Individual
MR. KERRY MINNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, LMFT, LCAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
87000437A
IN
1041C0700X
Clinical Social Worker
Primary
34000534A
IN
106H00000X
Marriage & Family Therapist
35000242A
IN
Other
Enumeration date
03/11/2007
Last updated
08/19/2013
Update your record
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