KENNETH HILLIARD

FORT WAYNE, IN
NPI1730838947
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2022-03-23
Last Update Date2022-03-23
Business Address
KENNETH HILLIARD
201 E RUDISILL BLVD STE B102
FORT WAYNE, IN 46806-1756
Phone number: 126-079-7589
Mailing Address
KENNETH HILLIARD
921 E DUPONT RD # 909
FORT WAYNE, IN 46825-1551
Phone number: 260-797-5892