Individual
KENNETH HOLLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPH, LCAC
Contact information
Practice address
2924 E DOUGLAS AVE, WICHITA, KS 67214-4709
(316) 265-8511
(316) 265-5047
Mailing address
2924 E DOUGLAS AVE, WICHITA, KS 67214-4709
(316) 265-8511
(316) 265-5047
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
168
KS
Other
Enumeration date
06/19/2014
Last updated
06/19/2014
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