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General NPI Number Information
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NPI Number | 1194581850
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Entity Type | Individual
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Provider Name | KENNETH R CARDER CPRS-HIGH SCHOOL
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Gender | Male
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Dates
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Enumeration Date | 02/21/2024
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Last Update Date | 02/21/2024
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Provider Practice Location Address
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Address Line | 1034 BROWN ST
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City | AKRON
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State | OH
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Zip | 44301-1515
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Country | US
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Telephone | 330-388-3922
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Fax |
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Provider Business Mailing Address
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Address Line | 73 S MAPLE ST
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City | AKRON
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State | OH
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Zip | 44302-1666
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Country | US
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Telephone | 330-962-5495
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | APS.004288
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License Number State | OH
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