Most Relevant Information
Provider Data
| NPI Number: | 1003582305 |
| Provider Name: | KENNIDY RAE SOUZA |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | E.2404582 |
Most Important Dates
| Enumeration Date: | 08/18/2021 |
| Last Updated: | 08/08/2024 |
Provider Practice Location
3493 BIGBY HOLLOW CT
COLUMBUS
OH
432289787
Practice Location Phone/Fax
| Phone: | 6144050463 |
| Fax: |
Provider Mailing Location
4947 ARCHDALE LN
COLUMBUS
OH
432142317
Provider Mailing Phone/Fax
| Phone: | 6148229052 |
| Fax: |