| NPI | 1780643072 |
|---|---|
| Former Name | MARY B KENIFIC |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW8791) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 3413) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2011-10-11 |