Most Relevant Information
Provider Data
| NPI Number: | 1003425646 |
| Provider Name: | KERRY HOWARD CAVISTON LMHC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | 11233 |
Most Important Dates
| Enumeration Date: | 07/29/2020 |
| Last Updated: | 07/29/2020 |
Provider Practice Location
32 MIDDLE ST APT 2
LEOMINSTER
MA
014533840
Practice Location Phone/Fax
| Phone: | 1978870311 |
| Fax: |
Provider Mailing Location
32 MIDDLE ST APT 2
LEOMINSTER
MA
014533840
Provider Mailing Phone/Fax
| Phone: | 1978870311 |
| Fax: |