Individual
KEVIN RONALD SIDDEN
Active
Individual
KEVIN RONALD SIDDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3713
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3713
NCBLPC
NC
Enumeration date
06/13/2008
Last updated
04/08/2013
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