Individual provider · Type 1 NPI

Kyle Vincent Conneally

Addiction (Substance Use Disorder) Counselor · San Pedro, CA

NPI number 1104432871 Active

Practice location

1003 S Beacon St
San Pedro, CA 90731-4324

Call (310) 514-4940 Map

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1104432871

Kyle Vincent Conneally's National Provider Identifier is 1104432871, issued on Sep 18, 2020. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in San Pedro, CA. The record was last updated on Sep 18, 2020.