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1407400856
KEONDRE DEJAWN THOMAS
FRESNO, CA
NPI
1407400856
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2019-07-24
Last Update Date
2019-07-24
Business Address
KEONDRE DEJAWN THOMAS
2772 S MARTIN LUTHER KING BLVD
FRESNO, CA 93727
Phone number: 559-265-4800
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Mailing Address
KEONDRE DEJAWN THOMAS
2772 S MARTIN LUTHER KING BLVD
FRESNO, CA 93706
Phone number:
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