Doctor Name: | MISS KENESA HOLNESS |
NPI Number: | 1053771311 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED. |
License Number: | |
Business Practice Address: | 246 Park St West Springfield, MA - 010893314 |
Business Phone Number: | 8607981567 |
Business Fax Number: | |
Mailing Address: | 106 Fox Hill Ln, ENFIELD |
State: | CT |
Postal Code: | 060823860 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 02/29/2016 |
NPI Last Update Date: | 02/29/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |