KENNETH SCOTT MARTIN

ROCKFORD, IL
NPI1255438362
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IL  13193)
Enumeration Date2006-09-20
Last Update Date2007-07-08
Business Address
Mr. KENNETH SCOTT MARTIN CADC
4940 E STATE ST
ROCKFORD, IL 61108-2270
Phone number: 815-227-0081
Mailing Address
Mr. KENNETH SCOTT MARTIN CADC
4940 E STATE ST
ROCKFORD, IL 61108-2270
Phone number: 815-227-0081
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