Provider Demographics
NPI:1891684148
Name:DUTRA, KENIA MOREIRA (MA ORDAINED MINISTER)
Entity type:Individual
Prefix:MRS
First Name:KENIA
Middle Name:MOREIRA
Last Name:DUTRA
Suffix:
Gender:F
Credentials:MA ORDAINED MINISTER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 ROUTE 130 S STE 510
Mailing Address - Street 2:
Mailing Address - City:CINNAMINSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08077-2844
Mailing Address - Country:US
Mailing Address - Phone:856-465-5364
Mailing Address - Fax:
Practice Address - Street 1:101 ROUTE 130 S STE 510
Practice Address - Street 2:
Practice Address - City:CINNAMINSON
Practice Address - State:NJ
Practice Address - Zip Code:08077-2844
Practice Address - Country:US
Practice Address - Phone:856-465-5364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral