Individual
KENARD YOUNGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3444 WISCONSIN AVE, VICKSBURG, MS 39180-5331
(601) 638-0031
Mailing address
3444 WISCONSIN AVE, VICKSBURG, MS 39180-5331
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/27/2016
Last updated
01/27/2016
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