Individual
KEN MACANKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
444 W FORT ST FL 2, BOISE, ID 83702-4535
(208) 422-1018
Mailing address
419 CENTER RD, EASTON, CT 06612-1649
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
01291963
CT
1041C0700X
Clinical Social Worker
Primary
—
CT
Other
Enumeration date
01/09/2008
Last updated
05/11/2026
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