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Individual
MR. KEVIN L HACKWORTH
Active
Individual
MR. KEVIN L HACKWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LPC, LLP
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401017843
MI
103TC0700X
Clinical Psychologist
6301016876
MI
Other
Enumeration date
09/19/2016
Last updated
05/30/2023
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