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1053609065
KEVIN CHARLES STORY
BERLIN, NJ
NPI
1053609065
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: NJ 101YM0800X)
Enumeration Date
2011-07-12
Last Update Date
2011-07-12
Business Address
-- KEVIN CHARLES STORY
128 CROSS KEYS RD
BERLIN, NJ 08009-9201
Phone number: 856-210-1511
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Mailing Address
-- KEVIN CHARLES STORY
19 E ORMOND AVE
CHERRY HILL, NJ 08034-2053
Phone number: 856-428-1300
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