Individual
MR. KENYATTA RASHON WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LCAS-A
Contact information
Practice address
2028 PHEASANT GLEN RD, CHARLOTTE, NC 28214-8208
(704) 705-0640
Mailing address
2028 PHEASANT GLEN RD, CHARLOTTE, NC 28214-8208
(704) 705-0640
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2828-A
NC
Other
Enumeration date
01/31/2013
Last updated
01/31/2013
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