Individual
KENNISE JOSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
72 MORA ST, DORCHESTER, MA 02124-4633
(617) 820-8742
Mailing address
72 MORA ST, DORCHESTER, MA 02124-4633
(617) 820-8742
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/17/2012
Last updated
10/17/2012
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