Individual
MR. KENNETH MARTIN DEBLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
3205 N TWYMAN RD, INDEPENDENCE, MO 64058-3211
(816) 249-5371
Mailing address
3205 N TWYMAN RD, INDEPENDENCE, MO 64058-3211
(816) 249-5371
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2013008640
MO
Other
Enumeration date
03/29/2013
Last updated
11/26/2020
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