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NPI Code Detail

MEDICARE: LEONELLE MAFEGUE KENNE

MEDICARE: LEONELLE MAFEGUE KENNE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianMD

General Provider Information

NPI Number : 1215870191
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEONELLE MAFEGUE KENNE
Provider Business Mailing Address
First Line : 903 21ST ST NE APT 303
Second Line :
City : WASHINGTON
State : DC
Zip : 20002-4170
Country : US
Telephone Number : 202-373-8715
Fax Number :
Provider Business Practice Location Address
First Line : 11720 BELTSVILLE DR STE 500A15
Second Line :
City : BELTSVILLE
State : MD
Zip : 20705-3166
Country : US
Telephone Number : 202-981-8060
Fax Number : 301-889-9735
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2026
Last Update Date : 04/14/2026

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Directions to “ LEONELLE MAFEGUE KENNE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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