Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1093214603 |
---|---|
Provider Name | Kathleen Marie Kerwin |
First Address | Albany, NY 12208-3409 |
Second Address | Albany, NY 12208-3409 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2018 |
Last Update Date | 09/02/2018 |