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Kennesha Nicole Willis

Behavior Technician in Rockville, MD. Individual provider (NPI-1).

NPI number1558083147
StatusActive
Last updated in NPPESSep 12, 2022

Details

NPI
1558083147
Entity type
Individual (NPI-1)
Name
Kennesha Nicole Willis
Sex
Female
Sole proprietor
No
Enumeration date
Sep 12, 2022
Certification date
Sep 12, 2022
Last updated
Sep 12, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
106S00000X Behavior Technician–MDYes

Practice location

1390 Piccard Dr Ste 100
Rockville, MD 20850-4368

Phone 301-327-5199

Mailing address

1390 Piccard Dr Ste 100
Rockville, MD 20850-4368

Phone 301-327-5199

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