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1487820056
SHONTA SMALLWOOD
FRESNO, CA
NPI
1487820056
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
Enumeration Date
2008-05-05
Last Update Date
2008-05-05
Business Address
SHONTA SMALLWOOD
2772 MARTIN LUTHER KING BLVD
FRESNO, CA 93706-5345
Phone number: 559-265-4800
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Mailing Address
SHONTA SMALLWOOD
1029 E JOLSON AVE
FRESNO, CA 93706-5548
Phone number:
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