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1730838947
KENNETH HILLIARD
FORT WAYNE, IN
NPI
1730838947
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2022-03-23
Last Update Date
2022-03-23
Business Address
KENNETH HILLIARD
201 E RUDISILL BLVD STE B102
FORT WAYNE, IN 46806-1756
Phone number: 126-079-7589
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Mailing Address
KENNETH HILLIARD
921 E DUPONT RD # 909
FORT WAYNE, IN 46825-1551
Phone number: 260-797-5892
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