Individual
ALLEN KENNETH CHALK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS,CAP
Contact information
Practice address
1251 N STONE ST, DELAND, FL 32720-2584
(386) 623-3361
Mailing address
36927 SLICE LN, GRAND ISLAND, FL 32735-8449
(352) 740-5517
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAP.0100572
FL
Other
Enumeration date
10/08/2024
Last updated
10/08/2024
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