KENNY WADE RICHARDSON

OMAHA, NE
NPI1801223110
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NE  396)
Enumeration Date2013-10-01
Last Update Date2013-10-01
Business Address
-- KENNY WADE RICHARDSON LADC
130 N 39TH ST
OMAHA, NE 68131-2307
Phone number: 402-558-7088
Mailing Address
-- KENNY WADE RICHARDSON LADC
130 N 39TH ST
OMAHA, NE 68131-2307
Phone number: 402-558-7088