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General NPI Number Information
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NPI Number | 1538730346
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Entity Type | Individual
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Provider Name | JOAN KENNEDY KLEJNA
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Gender | Female
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Dates
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Enumeration Date | 07/02/2021
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Last Update Date | 07/02/2021
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Provider Practice Location Address
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Address Line | 235 N PEARL ST
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City | BROCKTON
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State | MA
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Zip | 02301-1794
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Country | US
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Telephone | 508-427-2534
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Fax |
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Provider Business Mailing Address
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Address Line | 253 MAIN ST
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City | NORFOLK
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State | MA
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Zip | 02056-1345
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Country | US
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Telephone | 508-528-9107
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 106376-SW-LICSW
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License Number State | MA
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