Individual
MR. KENNETH J OLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
800 HAMPTON LN, CANTON, MO 63435-1032
(314) 277-4547
Mailing address
800 HAMPTON LN, CANTON, MO 63435-1032
(314) 277-4547
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2001007819
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
495347015
—
MO
Enumeration date
12/26/2006
Last updated
08/20/2008
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