Individual
KEN G YOUNGBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
47360 PHILOSOPHER CT, SOLDOTNA, AK 99669-9259
(928) 606-0916
Mailing address
47360 PHILOSOPHER CT, SOLDOTNA, AK 99669-9259
(928) 606-0916
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-3870
AZ
Other
Enumeration date
12/23/2010
Last updated
02/01/2017
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