NPI Profile for KEENA D CHARLES in WICHITA, KS.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Addiction (Substance Use Disorder) |
101YA0400X | |||
Community/Behavioral Health |
251S00000X |
| NPI Number | 1275012635 |
|
| Status | Active | |
| Credentials | LAC-TS | |
| Entity | Individual | |
| Enumeration date | 08/07/2018 | |
| Last updated | 04/29/2025 - More than a year ago | |
| Sole proprietor 1 | Yes | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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KEENA D CHARLES
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