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1104291079
STANLEY KEVIN THOMAS
PASADENA, CA
NPI
1104291079
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2015-12-03
Last Update Date
2015-12-03
Business Address
-- STANLEY KEVIN THOMAS ccapp, registrant
1680 N FAIR OAKS AVE
PASADENA, CA 91103-1642
Phone number: 323-907-4842
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Mailing Address
-- STANLEY KEVIN THOMAS ccapp, registrant
1680 N FAIR OAKS AVE
PASADENA, CA 91103-1642
Phone number: 323-907-4842
Copy
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