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Organization

KINERA FOUNDATION, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTY RUSSELL (PRESIDENT)
(443) 249-3126
Entity
Organization

Contact information

Practice address
115 SALLITT DR, SUITE C, STEVENSVILLE, MD 21666-2156
(443) 249-3126
Mailing address
115 SALLITT DR, SUITE C, STEVENSVILLE, MD 21666-2156
(443) 249-3126

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
06759
MD
235Z00000X
Speech-Language Pathologist
Primary
MD

Other

Enumeration date
07/13/2016
Last updated
07/13/2016
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