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Individual

KEAYON DONTRE THOMAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1865 GUMBERRY CT, HOPE MILLS, NC 28348-8421
(910) 710-4520
Mailing address
1865 GUMBERRY CT, HOPE MILLS, NC 28348-8421
(910) 710-4520

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
996140124
UNITED HEALTHCARE
NC
Enumeration date
11/17/2022
Last updated
11/17/2022
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