WANDA MARIE KENNEL LCDC, LSBW
NPI 1144278714
Counselor - Addiction (Substance Use Disorder) in Gilmer, TX
Active since May 05, 2006
About Wanda Marie Kennel Lcdc, Lsbw NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WANDA MARIE KENNEL LCDC, LSBW (NPI 1144278714) is an individual addiction (substance use disorder) provider in Gilmer, Texas, licensed in Texas (5922) and active in the NPI registry since May 2006.
NPPES Registry Identity
NPI1144278714
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameWANDA MARIE KENNELCredential: LCDC, LSBW
Location Address6563 HIGHLAND RDGilmer, TX 75645-8279
Mailing Address6563 Highland RdGilmer, TX 75645-8279 · (903) 734-5592
Phone(903) 734-5592
Sole ProprietorNo
Enumeration DateMay 5, 2006
Last NPPES UpdateSeptember 17, 2007
✔ NPI 1144278714 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in TX · 5922
6563 HIGHLAND RD, Gilmer, TX 75645
Other Identifiers 2
Other5922TX · Lcdc
OtherS23305TX · Lbsw
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1144278714, enumerated as an "individual" on May 05, 2006.
The provider is located at 6563 HIGHLAND RD GILMER, TX 75645 and the phone number is (903) 734-5592.
Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
