Individual
KENNA MIRANDA WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1672 COLUMBIA HWY, DOTHAN, AL 36303-5434
(334) 712-6400
Mailing address
116 COUNTY ROAD 610, ENTERPRISE, AL 36330-5232
(334) 447-0602
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
4526
AL
Other
Enumeration date
10/04/2021
Last updated
10/04/2021
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