Individual
PHABIAN TREYVONNE DEJEAN
Active
Individual
PHABIAN TREYVONNE DEJEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
0019259
WI
Other
Enumeration date
11/28/2022
Last updated
11/28/2022
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