Individual
DR. KEVIN HAWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
250 N SUNNY SLOPE RD STE 203, BROOKFIELD, WI 53005-4824
(262) 782-2820
Mailing address
2519 CROASDAILE FARM PKWY APT 10, DURHAM, NC 27705-2266
(206) 321-5331
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3748-57
WI
Other
Enumeration date
01/22/2020
Last updated
01/28/2020
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