Kenyetta S Douglass

NPI #1013719152 in Canton, Ohio

Provider Information

NPI Number: 1013719152
Entity Type: Individual
Name: Kenyetta S Douglass
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Peer Specialist
Enumeration Date: Mar 27, 2025
Last Updated: Mar 27, 2025

Practice Location

Address: 131 WERTZ AVE NW
City: Canton
State: Ohio
ZIP Code: 44708-4171
Phone: (234) 214-8470

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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