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General NPI Number Information
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NPI Number | 1790167377
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Entity Type | Organization
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Legal Business Name | ALICIA KENDORSKI, NCC
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Dates
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Enumeration Date | 06/19/2015
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Last Update Date | 06/19/2015
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Provider Practice Location Address
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Address Line | 32630 CEDAR DR UNIT A
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City | MILLVILLE
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State | DE
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Zip | 19967-6946
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Country | US
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Telephone | 302-448-5054
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Fax |
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Provider Business Mailing Address
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Address Line | 24583 PETERKINS ROAD
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City | GEORGETOWN
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State | DE
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Zip | 19947
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Country | US
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Telephone | 302-448-5054
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. ALICIA MARY KENDORSKI
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Credential | NCC
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Telephone | 302-448-5054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0000091
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License Number State | DE
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