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1336481514
KYLE D JENNINGS
BLOOMINGTON, IL
NPI
1336481514
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2013-03-26
Last Update Date
2013-11-01
Business Address
-- KYLE D JENNINGS B.S.
702 W CHESTNUT ST
BLOOMINGTON, IL 61701-2814
Phone number: 309-557-1472
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Mailing Address
-- KYLE D JENNINGS B.S.
702 W CHESTNUT ST
BLOOMINGTON, IL 61701-2814
Phone number: 309-557-1472
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