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1790141687
GARY KENYON
AVONDALE, AZ
NPI
1790141687
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2016-01-07
Last Update Date
2016-01-07
Business Address
-- GARY KENYON
12918 W PALM LN
AVONDALE, AZ 85392-7153
Phone number: 469-781-8182
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Mailing Address
-- GARY KENYON
PO BOX 1891
SNOWFLAKE, AZ 85937-1891
Phone number: 469-781-8182
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