Provider Demographics
NPI:1154791440
Name:KINNIN, REBECCA LEIGH (MHCP)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LEIGH
Last Name:KINNIN
Suffix:
Gender:F
Credentials:MHCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 ALYS DR E
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-1403
Mailing Address - Country:US
Mailing Address - Phone:716-715-2643
Mailing Address - Fax:
Practice Address - Street 1:3176 ABBOTT RD STE 500
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1069
Practice Address - Country:US
Practice Address - Phone:716-822-2117
Practice Address - Fax:716-822-8165
Is Sole Proprietor?:No
Enumeration Date:2015-09-30
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor