Individual
KANDIS PAULINE BANNISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
413 NEPONSET AVE STE 1, BOSTON, MA 02122-3184
(617) 675-2912
Mailing address
413 NEPONSET AVE STE 1, BOSTON, MA 02122-3184
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/29/2023
Last updated
09/29/2023
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