Provider Information for 1053099564
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AMBRIEL KINNEY MSW, LCSW
Sex: Female
NPI: 1053099564
Last Updated: 2024-12-20
Certification Date: 2024-12-20
Certification Date: 2024-12-20
Details
| Name | Value | ||||||||||||||||
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| NPI | 1053099564 | ||||||||||||||||
| Enumeration Date | 2023-07-06 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 612 SADDLE CREEK DR OXFORD, MS 38655-8188 United States Phone: 662-809-6397 | Fax: | ||||||||||||||||
| Primary Practice Address | 612 SADDLE CREEK DR OXFORD, MS 38655-8188 United States Phone: 662-809-6397 | Fax: | ||||||||||||||||
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