Individual
MR. KENNETH SCOTT MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
4940 E STATE ST, ROCKFORD, IL 61108-2270
(815) 227-0081
(815) 387-5316
Mailing address
4940 E STATE ST, ROCKFORD, IL 61108-2270
(815) 227-0081
(815) 387-5316
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13193
IL
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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