Individual
MR. KEANE QUANTAZE SAULS SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCAS
Contact information
Practice address
1709 CENTRE ST W, WILSON, NC 27893-2781
(919) 801-5028
Mailing address
1709 CENTRE ST W, WILSON, NC 27893-2781
(919) 737-4895
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
13875
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20283
NC
Other
Enumeration date
11/17/2014
Last updated
08/16/2023
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