| Doctor Name: | KANDIS JUNE KANINE |
| NPI Number: | 1215994694 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A., AAC, GMHS |
| License Number: | 6401004169 |
| Business Practice Address: | 1000 E Sturgis St Saint Johns, MI - 488792068 |
| Business Phone Number: | 9892245309 |
| Business Fax Number: | 5173468291 |
| Mailing Address: | 2428 W Reynolds Ave, CENTRALIA |
| State: | WA |
| Postal Code: | 985314554 |
| Phone Number: | 6303309044 |
| Fax Number: | 3607363139 |
| NPI Enumeration Date: | 04/28/2006 |
| NPI Last Update Date: | 12/10/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 6401004169 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |