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Individual

MR. KENNETH CLARK KOMYATHY

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
55 MDOS SGO, 2501 CAPEHART ROAD, OFFUTT A F B, NE 68113-1712
(402) 294-7886
(402) 232-7291
Mailing address
55 MDOS SGO, 2501 CAPEHART ROAD, OFFUTT A F B, NE 68113-1712
(402) 294-7886
(402) 232-7291

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1084
NE

Other

Enumeration date
08/31/2005
Last updated
07/08/2007
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