Kenneth John De Haan LCSW

NPI 1174643753 - Social Worker - 1041C0700X

NPI Details
NPI 1174643753
Gender Male
Enumeration Date 03/29/2007
Last Updated 06/11/2013
Entity Type Individual
Active Over 9 years ago
Practice Location
704 WEST 8TH STREET
SAN PEDRO CA, 90731, US
Phone (310) 832-7545
Fax (310) 833-8580
Business Location
704 W 8TH ST
SAN PEDRO CA, 90731-3017, US
Phone (310) 832-7545
Fax (310) 833-8580
Toxanomy
Taxonomy Code 1041C0700X
License State California
License Number LCS13281
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According to our database, Mr. Kenneth John De Haan LCSW NPI is 1174643753, taxonomy code is 1041C0700X and license number is LCS13281, license state is located at California. Kenneth John De Haan LCSW physically located at 704 West 8th Street, San Pedro CA, 90731. NPI Number Kenneth John De Haan LCSW has the Individual type.

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1174643753 NPI number is provided on an as is basis without warranty of any kind. 1174643753 is maintained by the National Plan & Provider Enumeration System. The contents of Kenneth John De Haan LCSW are for informational purposes only.