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1376957373
SHANA GAVIGLIO KENNEY
SAN RAFAEL, CA
NPI
1376957373
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
251S00000X Community/Behavioral Health
Enumeration Date
2014-06-17
Last Update Date
2014-06-17
Business Address
SHANA GAVIGLIO KENNEY
1665 GRAND AVE
SAN RAFAEL, CA 94901-2211
Phone number: 415-258-9572
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Mailing Address
SHANA GAVIGLIO KENNEY
1665 GRAND AVE
SAN RAFAEL, CA 94901-2211
Phone number: 415-258-9572
Copy
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