Kenneth Charles Bishop, CDCA,PEER SUPPOT

NPI #1497307946 in Lyndhurst, Ohio

Provider Information

NPI Number: 1497307946
Entity Type: Individual
Name: Kenneth Charles Bishop, CDCA,PEER SUPPOT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Peer Specialist
Credential: CDCA,PEER SUPPOT
Enumeration Date: Jul 15, 2019
Last Updated: Jul 15, 2019

Practice Location

Address: 5257 ASHWOOD DR
City: Lyndhurst
State: Ohio
ZIP Code: 44124-1037
Phone: (216) 870-9796

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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