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General NPI Number Information
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NPI Number | 1548661879
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Entity Type | Individual
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Provider Name | KELLY RAE KAMINSKI M.S., NCSP
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Gender | Female
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Dates
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Enumeration Date | 09/05/2014
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Last Update Date | 09/05/2014
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Provider Practice Location Address
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Address Line | 559 KING ST
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City | CHARLESTON
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State | SC
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Zip | 29403-7504
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Country | US
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Telephone | 843-277-0493
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Fax |
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Provider Business Mailing Address
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Address Line | 11127 10TH AVENUE CT E APARTMENT A303
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City | TACOMA
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State | WA
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Zip | 98445-7076
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Country | US
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Telephone | 412-848-9471
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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