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1255893640
KHALEEL- SHANE DESHAWN JETT
SAN LEANDRO, CA
NPI
1255893640
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2019-04-03
Last Update Date
2019-04-03
Business Address
KHALEEL- SHANE DESHAWN JETT
2275 ARLINGTON DR
SAN LEANDRO, CA 94578-1132
Phone number: 510-317-1444
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Mailing Address
KHALEEL- SHANE DESHAWN JETT
2275 ARLINGTON DR
SAN LEANDRO, CA 94578-1132
Phone number: 510-317-1444
Copy
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