Individual
MR. KENNETH EDWARD HOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2779 WEST RD, MOUNTAIN HOME, AR 72653-6873
(870) 404-7735
Mailing address
2779 WEST ROAD, MOUNTAIN HOME, AR 72653
(870) 404-7735
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1287-C
AR
Other
Enumeration date
09/23/2011
Last updated
09/23/2011
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