Keenan Ray Tom Smith
Keenan Ray Tom Smith is a Rehabilitation Counselor in Ukiah, California. Practices as a sole proprietor. Registered with an NPI since 2020.
- In the registry since
- 2020
Practice location Address checks out
776 S State St Ste 107Ukiah, CA 95482-5858
Phone: (707) 463-4915
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Rehabilitation Counselor (primary) | Taxonomy 225C00000X |
|---|
Record details
| NPI number | 1912500513 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | November 17, 2020 |
| Last updated in NPPES | November 17, 2020 |
| Certification date | November 17, 2020 |
| Mailing address | 776 S State St Ste 107, Ukiah, CA 95482-5858 |