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1104044148
KENYON Q COLE
INGLEWOOD, CA
NPI
1104044148
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-04-23
Last Update Date
2007-07-08
Business Address
Mr. KENYON Q COLE
8619 CRENSHAW BLVD
INGLEWOOD, CA 90305-2330
Phone number: 310-677-9019
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Mailing Address
Mr. KENYON Q COLE
8619 CRENSHAW BLVD
INGLEWOOD, CA 90305-2330
Phone number: 310-677-9019
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