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Individual

KENNETH MATTHEW DECINA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3418 QUANTUM LAKES DR, BOYNTON BEACH, FL 33426-8340
(954) 937-1481
Mailing address
3418 QUANTUM LAKES DR, BOYNTON BEACH, FL 33426-8340
(954) 937-1481

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MH20655
FL

Other

Enumeration date
10/03/2022
Last updated
10/03/2022
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