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Individual
CHARLES A KUYKENDALL
Active
Individual
CHARLES A KUYKENDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC CAC II MAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1210026
SC
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
331
SC
Other
Enumeration date
09/06/2013
Last updated
06/04/2024
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