Individual
KENNETH ANDREW HARRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
117 PARKWOOD AVE, MACON, GA 31210-5018
(478) 477-2220
Mailing address
114 PEACHTREE BLVD, BONAIRE, GA 31005-4040
(478) 218-4646
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW003458
GA
Other
Enumeration date
06/17/2007
Last updated
07/08/2007
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