Individual
MS. AUDRA J KINNER
Active
Individual
MS. AUDRA J KINNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW LICSWMA
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
102054
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851845
—
MA
01
—
P05710
BCBS ANTHEM BC
CT
01
—
P05710
BCBS
MA
Enumeration date
01/19/2007
Last updated
07/09/2007
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