Healthcare Provider Details

I. General information

NPI: 1013828763
Provider Name (Legal Business Name): KINERA FOUNDATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 E WATER ST STE 110
CENTREVILLE MD
21617-1155
US

IV. Provider business mailing address

115 SALLITT DR STE C
STEVENSVILLE MD
21666-2156
US

V. Phone/Fax

Practice location:
  • Phone: 443-249-3126
  • Fax:
Mailing address:
  • Phone: 443-249-3126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: KATE SANDERS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 443-249-3126