MARVIN CARL KIDWELL

LEXINGTON, KY
NPI1043496680
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YP2500X Counselor, Professional
(Licence: KY  KY-1058)
Additional Taxonomies101YM0800X Counselor, Mental Health
(Licence: FL  MH8993)
1041C0700X Social Worker, Clinical
(Licence: FL  MH8993)
Enumeration Date2008-01-14
Last Update Date2011-12-14
Business Address
-- MARVIN CARL KIDWELL
274 SOUTHLAND DR SUITE # 204
LEXINGTON, KY 40503-1946
Phone number: 859-457-1679
Mailing Address
-- MARVIN CARL KIDWELL
2145 LARKSPUR DR
LEXINGTON, KY 40504-3501
Phone number: 859-457-1679