Individual
KENNETH PROVINCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1355 BRUSHY MOUNTAIN RD, WILKESBORO, NC 28697-8478
(336) 818-0733
Mailing address
1355 BRUSHY MOUNTAIN RD, WILKESBORO, NC 28697-8478
(336) 818-0733
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
A7810
NC
Other
Enumeration date
03/29/2010
Last updated
03/29/2010
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