Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. KENNETH WAYNE DAVIS, SAC
ActiveAddiction (Substance Use Disorder) Counselor · BENTONVILLE, AR
Registration Details
- NPI Number
- 1124384359
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 2, 2012 (14.055702803775 yrs)
- Last Updated
- Nov 6, 2013
- License
-
15651131 (WI)
Practice Information
- Address
-
1002 SE C STBENTONVILLE, AR, 727126327Browse AR providers · Browse ZIP 72712
- Phone
- 4792712120
- Fax
- 4792712219
- Primary Specialty
-
Addiction (Substance Use Disorder) Counselor
101YA0400X
Other Addiction (Substance Use Disorder) Counselor Providers in BENTONVILLE, AR
| Name | Credential | NPI |
|---|---|---|
| MATTHEW WALKER LONG | MA | 1366871642 |
| MANDA J DAVIS | LADAC,BCC | 1346679636 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.