Individual
KENNETH WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC, CODP I
Contact information
Practice address
1607 JOHN DEERE RD, EAST MOLINE, IL 61244-9607
(309) 792-0292
Mailing address
1607 JOHN DEERE RD, EAST MOLINE, IL 61244-9607
(309) 792-0292
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
36152
IL
Other
Enumeration date
08/03/2024
Last updated
08/03/2024
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