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1972092401
KENNETH L. GRAVES
MANSFIELD, OH
NPI
1972092401
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH 140444)
Enumeration Date
2018-05-10
Last Update Date
2018-05-10
Business Address
KENNETH L. GRAVES
400 BOWMAN ST
MANSFIELD, OH 44903-1235
Phone number: 419-610-1428
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Mailing Address
KENNETH L. GRAVES
400 BOWMAN ST
MANSFIELD, OH 44903-1235
Phone number: 419-610-1428
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