Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1215571716 |
---|---|
Provider Name | Dr. Julwel Ann Kenney |
First Address | Maywood, NJ 07607-1830 |
Second Address | Montclair, NJ 07042-4725 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2019 |
Last Update Date | 29/10/2019 |