Provider Demographics
NPI:1770016578
Name:TOUSSAINT, KENSON
Entity Type:Individual
Prefix:
First Name:KENSON
Middle Name:
Last Name:TOUSSAINT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 PALM BEACH LAKES BLVD STE 300D
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-6515
Mailing Address - Country:US
Mailing Address - Phone:561-337-4338
Mailing Address - Fax:561-337-9025
Practice Address - Street 1:2001 PALM BEACH LAKES BLVD STE 300D
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-6515
Practice Address - Country:US
Practice Address - Phone:561-337-4338
Practice Address - Fax:561-337-9025
Is Sole Proprietor?:No
Enumeration Date:2017-04-07
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker