Individual
MR. KYLE JACKSON KRESSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
919 12TH PL STE 13, PRESCOTT, AZ 86305-1433
(844) 762-3748
Mailing address
919 12TH PL STE 13, PRESCOTT, AZ 86305-1433
(844) 762-3748
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LAC-22785
AZ
Other
Enumeration date
07/08/2024
Last updated
07/08/2024
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