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Individual

KWASI KEMNU AMPONSA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
467 CROWN DR APT 202, FORT MILL, SC 29708-8601
(803) 357-4041
Mailing address
PO BOX 1211, FORT MILL, SC 29716-1211
(803) 357-4041

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
06/30/2022
Last updated
06/30/2022
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