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General NPI Number Information
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NPI Number | 1902391352
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Entity Type | Individual
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Provider Name | SARA ANN KENOSKY LSW
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Gender | Female
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Dates
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Enumeration Date | 06/28/2018
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Last Update Date | 06/28/2018
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Provider Practice Location Address
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Address Line | 201 HOSPITAL DR
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City | DOVER
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State | OH
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Zip | 44622-2058
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Country | US
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Telephone | 330-343-6631
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Fax | 234-801-4374
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Provider Business Mailing Address
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Address Line | 128 TAYLOR AVE
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City | DENNISON
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State | OH
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Zip | 44621-1666
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Country | US
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Telephone | 330-987-2012
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | S.1802067
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License Number State | OH
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