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1174871206
DIONSHAE WISHUM
MODESTO, CA
NPI
1174871206
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2012-08-21
Last Update Date
2018-09-28
Business Address
DIONSHAE WISHUM
1235 MCHENRY AVE
MODESTO, CA 95350-5370
Phone number: 209-527-4597
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Mailing Address
DIONSHAE WISHUM
500 W HOSPITAL RD
FRENCH CAMP, CA 95231-9693
Phone number: 209-468-6857
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