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1396055158
KENNETH M BAKONDI
CORVALLIS, OR
NPI
1396055158
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2010-10-14
Last Update Date
2010-10-14
Business Address
-- KENNETH M BAKONDI
557 NW MONROE AVE
CORVALLIS, OR 97330-4721
Phone number: 541-766-6147
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Mailing Address
-- KENNETH M BAKONDI
2010 SW 3RD ST UNIT 21
CORVALLIS, OR 97333-1789
Phone number: 541-752-1705
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