KEITH THOMAS SIMMONS

FOLSOM, CA
NPI1619614732
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: CA  CI41460124)
Enumeration Date2022-05-19
Last Update Date2024-06-12
Business Address
KEITH THOMAS SIMMONS
130 PROSPECTOR CT
FOLSOM, CA 95630-5119
Phone number: 916-293-9667
Mailing Address
KEITH THOMAS SIMMONS
130 PROSPECTOR CT
FOLSOM, CA 95630-5119
Phone number: 916-293-9667
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