Individual
MR. KENNETH WAYNE GATES
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M SW
Contact information
Practice address
4800 MEMORIAL DR, WACO, TX 76711-1329
(254) 356-5297
Mailing address
204 WHITE HALL RD, WACO, TX 76712-3850
(254) 776-1393
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
14494
TX
Other
Enumeration date
05/22/2006
Last updated
07/08/2007
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