Individual
DR. KENNETH B MASI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD,
Contact information
Practice address
105 W JEFFERSON ST, BLOOMINGTON, IL 61701-3904
(309) 532-3700
Mailing address
105 W JEFFERSON ST, BLOOMINGTON, IL 61701-3904
(309) 532-3700
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
—
Other
Enumeration date
04/26/2012
Last updated
04/26/2012
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