Individual
MARK GREGORY KINNAMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC
Contact information
Practice address
933 E PIERCE ST, COUNCIL BLUFFS, IA 51503-4626
(712) 396-4387
(712) 396-7708
Mailing address
933 E PIERCE ST, COUNCIL BLUFFS, IA 51503-4626
(712) 396-4387
(712) 396-7708
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/13/2010
Last updated
04/13/2010
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