Individual
MR. KENNETH GEORGE FOURNIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
500 N US HIGHWAY 89, PRESCOTT, AZ 86313-5001
(928) 445-4860
(928) 776-6116
Mailing address
500 N. HIGHWAY 89, PRESCOTT, AZ 86313-0000
(928) 445-4860
(928) 445-6116
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
13543
AZ
1041C0700X
Clinical Social Worker
Primary
5416
MN
Other
Enumeration date
06/26/2012
Last updated
06/26/2012
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