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Individual

MR. KENNETH WAYNE BABCOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSW,LICSW, QCSW,DCSW

Contact information

Practice address
265 NONNAMAKER DR, FAYETTEVILLE, AR 72701-7160
(425) 238-4883
Mailing address
265 NONNAMAKER DR, FAYETTEVILLE, AR 72701-7160
(425) 238-4883

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW60176690
WA

Other

Enumeration date
02/11/2011
Last updated
04/09/2012
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