Individual
KEONI SABLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
22515 E MUNOZ ST, QUEEN CREEK, AZ 85142-9152
(209) 585-0395
Mailing address
22515 E MUNOZ ST, QUEEN CREEK, AZ 85142-9152
(209) 596-3873
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
133337
CA
101YM0800X
Mental Health Counselor
Primary
15974
AZ
Other
Enumeration date
09/06/2019
Last updated
09/20/2023
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