NPI | 1750502670 |
---|---|
Other Name | GREGORY CARL KENNON |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 2707) |
Enumeration Date | 2007-05-01 |
Last Update Date | 2007-07-08 |