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Kenneth Michael Lott
Addiction (Substance Use Disorder) Counselor in San Rafael, California
NPI 1487378444

Kenneth Michael Lott is an Addiction (Substance Use Disorder) Counselor based in Martinez, CA and is specialized in Addiction (Substance Use Disorder). Kenneth Michael Lott practices in San Rafael, CA. The NPI Number for Kenneth Michael Lott is 1487378444 and holds a License No. R146110322 (California).

The current practice location address for Kenneth Michael Lott is 13 Peter Behr Dr, San Rafael, CA and can be reached out via phone at 415-473-4119.

Location: 13 Peter Behr Dr, San Rafael, CA, 94553-2117
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1487378444
Provider Name
Kenneth Michael Lott
Credential
Provider Entity Type
Individual
Gender
Male
Address
13 Peter Behr Dr, San Rafael, CA, 94553-2117
Phone Number
415-473-4119
Fax Number
Provider Enumeration Date
10/03/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
13 Peter Behr Dr
City
San Rafael
State
California
Zip
94903-5216
Phone Number
415-473-4119
Fax Number
person
Provider Business Mailing Address Details
Address
13 Peter Behr Dr
City
San Rafael
State
California
Zip
94903-5216
Phone Number
415-473-4119
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
R146110322 (California)
Definition
Definition to come...
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