| Mr Kenneth Wayne Davis, SAC | |
|
1002 Se C St, Bentonville, AR 72712-6327 | |
| (479) 271-2120 | |
| (479) 271-2219 |
| Full Name | Mr Kenneth Wayne Davis |
|---|---|
| Gender | Male |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1002 Se C St, Bentonville, Arkansas |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124384359 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 15651131 (Wisconsin) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Kenneth Wayne Davis, SAC 1002 Se C St, Bentonville, AR 72712-6327 Ph: (479) 271-2120 | Mr Kenneth Wayne Davis, SAC 1002 Se C St, Bentonville, AR 72712-6327 Ph: (479) 271-2120 |
Maria Goostree, Counselor Medicare: Not Enrolled in Medicare Practice Location: 602 N Walton Blvd, Bentonville, AR 72712 Phone: 479-464-1060 Fax: 479-271-6307 | |
Alexandra Smith, Counselor Medicare: Not Enrolled in Medicare Practice Location: 602 N Walton Blvd, Bentonville, AR 72712 Phone: 479-464-1060 Fax: 479-271-6307 | |
Blanca Ramos, Counselor Medicare: Not Enrolled in Medicare Practice Location: 602 N Walton Blvd, Bentonville, AR 72712 Phone: 479-464-1060 Fax: 479-271-6307 | |
Jana E Johnson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 602 N Walton Blvd, Bentonville, AR 72712 Phone: 479-464-1060 | |
Erich C Campbell, Counselor Medicare: Not Enrolled in Medicare Practice Location: 910 Se 21st St, Bentonville, AR 72712 Phone: 479-367-1110 | |
Melissa A Endicott, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2003 Se Walton Blvd, Bentonville, AR 72712 Phone: 479-750-2020 Fax: 479-750-4843 | |
Payton Journagan, Counselor Medicare: Not Enrolled in Medicare Practice Location: 602 N Walton Blvd, Bentonville, AR 72712 Phone: 479-464-1060 |