Individual provider · Type 1 NPI

Kenneth Wibowo Pranoto

Mental Health Counselor · Houston, TX

NPI number 1619736071 Active

Practice location

2425 Holly Hall St Apt A4
Houston, TX 77054-3930

Call (832) 409-8767 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X108149 (TX)

Mental Health Counselor: Definition to come...

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About NPI 1619736071

Kenneth Wibowo Pranoto's National Provider Identifier is 1619736071, issued on Mar 18, 2024. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Houston, TX. The record was last updated on Mar 18, 2024.