Individual
MRS. KATELYN M KIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, RDT ,LCAT
Contact information
Practice address
680 BLOOMFIELD AVE APT 2, BLOOMFIELD, NJ 07003-4352
(862) 283-0386
Mailing address
680 BLOOMFIELD AVE APT 2, BLOOMFIELD, NJ 07003-4352
(862) 283-0386
Taxonomy
Speciality
Code
Description
License number
State
101200000X
Drama Therapist
Primary
002670-01
NY
Other
Enumeration date
01/11/2024
Last updated
01/11/2024
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