Individual
DEQUAN TERELL CHRISTOPHER THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
525 N TRYON ST, CHARLOTTE, NC 28202-0202
(914) 484-3940
Mailing address
6408 MACROOM MEADOWS LN, HOUSTON, TX 77048-4078
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NC
Other
Enumeration date
02/03/2022
Last updated
02/03/2022
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