Healthcare Provider Details

I. General information

NPI: 1376748020
Provider Name (Legal Business Name): KELLI LYNN KUZNIAR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 54TH ST
WEST PALM BEACH FL
33407-2436
US

IV. Provider business mailing address

900 54TH ST
WEST PALM BEACH FL
33407-2436
US

V. Phone/Fax

Practice location:
  • Phone: 561-842-2406
  • Fax: 561-863-5379
Mailing address:
  • Phone: 561-842-2406
  • Fax: 561-863-5379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW6534
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: