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Individual
MR. KENNETH ANDERSON
Active
Individual
MR. KENNETH ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LBSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802074265
MI
Other
Enumeration date
10/07/2008
Last updated
05/21/2013
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