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General NPI Number Information
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NPI Number | 1821449554
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Entity Type | Individual
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Provider Name | KENNETH WINFREY
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Gender | Male
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Dates
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Enumeration Date | 06/23/2016
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Last Update Date | 06/23/2016
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Provider Practice Location Address
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Address Line | 1750 LINWOOD LOOP
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City | OPELOUSAS
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State | LA
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Zip | 70570-1660
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Country | US
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Telephone | 337-363-3703
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Fax | 337-363-4008
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Provider Business Mailing Address
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Address Line | 1750 LINWOOD LOOP
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City | OPELOUSAS
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State | LA
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Zip | 70570-1660
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Country | US
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Telephone | 337-363-3703
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Fax | 337-363-4008
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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