Individual
MR. KENNETH J DEVLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
3440 BLUE SULPHUR GDNS, ONA, WV 25545-9757
(304) 634-7238
(304) 733-2229
Mailing address
3440 BLUE SULPHUR GDNS, ONA, WV 25545-9757
(304) 634-7238
(304) 733-2229
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
362
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0163332000
APS HEALTHCARE
WV
05
—
0163332000
—
WV
01
—
021698
VALUE OPTIONS
WV
01
—
1002524
BRICKSTREET
WV
01
—
1689751059
TRICARE
WV
Enumeration date
11/01/2006
Last updated
08/13/2014
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