Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. KENNETH WALLACE LANDEAU, COTA/L
Active Sole ProprietorMR. KENNETH WALLACE LANDEAU, COTA/L is a Behavioral Health, Residential healthcare provider located in HAUPPAUGE, New York. NPI 1972617173 is currently active in the NPPES registry. Verify at CMS.
Behavioral Health, Residential · HAUPPAUGE, NY
Registration Details
- NPI Number
- 1972617173
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 18, 2006 (20.026318352492 yrs)
- Last Updated
- Jul 8, 2007
- License
-
005537-1 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
120 PLANT AVEHAUPPAUGE, NY, 117883805Browse NY providers · Browse ZIP 11788
- Phone
- 6318513810
- Primary Specialty
-
Behavioral Health, Residential
251C00000X
Other Behavioral Health, Residential Providers in HAUPPAUGE, NY
| Name | Credential | NPI |
|---|---|---|
| MRS. JENNIFER LULEEN DOLAN | — | 1265682595 |
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.