Individual
MISS KEANNE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8846 N 30TH AVE, PHOENIX, AZ 85051-3919
(516) 439-6153
Mailing address
8846 N 30TH AVE, PHOENIX, AZ 85051-3919
(516) 439-6153
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
04/27/2022
Last updated
04/27/2022
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