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General NPI Number Information
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NPI Number | 1063701910
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Entity Type | Individual
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Provider Name | KENIA ARTIS MSW, CADC, CASAC
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Gender | Female
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Dates
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Enumeration Date | 03/31/2011
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Last Update Date | 03/31/2011
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Provider Practice Location Address
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Address Line | 499 COOPER LANDING RD
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City | CHERRY HILL
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State | NJ
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Zip | 08002-2504
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Country | US
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Telephone | 856-428-4357
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Fax | 856-665-5193
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Provider Business Mailing Address
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Address Line | 19 E ORMOND AVE
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City | CHERRY HILL
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State | NJ
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Zip | 08034-2053
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Country | US
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Telephone | 856-428-1300
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 37CA00071000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 17340
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License Number State | NY
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