Individual
DIANA DESHAWN THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAADAC1, CPS
Contact information
Practice address
2551 W KEARNEY ST, SPRINGFIELD, MO 65803-2034
(417) 210-6025
(417) 869-4280
Mailing address
2551 W KEARNEY ST, SPRINGFIELD, MO 65803-2034
(417) 210-6025
(417) 869-4280
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14230
MO
101YA0400X
Addiction (Substance Use Disorder) Counselor
14531
MO
Other
Enumeration date
06/07/2022
Last updated
06/07/2022
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