Doctor Name: | KENNETH A BOERNER |
NPI Number: | 1043348410 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LISW-S |
License Number: | I9219 |
Business Practice Address: | 2845 Bell St Zanesville, OH - 437011720 |
Business Phone Number: | 7404549766 |
Business Fax Number: | 7405886452 |
Mailing Address: | 2845 Bell St, ZANESVILLE |
State: | OH |
Postal Code: | 437011720 |
Phone Number: | 7404549766 |
Fax Number: | 7405886452 |
NPI Enumeration Date: | 02/28/2007 |
NPI Last Update Date: | 07/26/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | I9219 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |