Individual
MR. KENNETH ROBERT KERNAGIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
2130 FARMINGTON AVE, A, FARMINGTON, NM 87401-2123
(505) 325-2323
Mailing address
3007 MARQUETTE AVE, FARMINGTON, NM 87402-4537
(505) 327-7239
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0105601
NM
Other
Enumeration date
12/12/2013
Last updated
12/12/2013
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