Individual
MR. GREG KENNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCDC
Contact information
Practice address
1631 E 2ND ST STE A, AUSTIN, TX 78702-4491
(512) 472-6261
(512) 472-5857
Mailing address
1430 COLLIER ST, AUSTIN, TX 78704-2911
(512) 445-7787
(512) 440-4059
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2707
TX
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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