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1467061127
KENNETH M. WANYA
ALBUQUERQUE, NM
NPI
1467061127
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NM 0082931)
Enumeration Date
2020-07-29
Last Update Date
2020-07-29
Business Address
KENNETH M. WANYA
1528 FIVE POINTS RD SW
ALBUQUERQUE, NM 87105-3179
Phone number: 505-242-2696
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Mailing Address
KENNETH M. WANYA
1528 FIVE POINTS RD SW
ALBUQUERQUE, NM 87105-3179
Phone number: 505-242-2696
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