Keenan Ray Tom Smith
NPI #1912500513 in Ukiah, California
Provider Information
- NPI Number
- 1912500513
- Entity Type
- Individual
- Name
- Keenan Ray Tom Smith
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Rehabilitation Counselor
- Enumeration Date
- Nov 17, 2020
- Last Updated
- Nov 17, 2020
Practice Location
- Address
- 776 S STATE ST STE 107
- City
- Ukiah
- State
- California
- ZIP Code
- 95482-5858
- Phone
- (707) 463-4915
Specialties & Taxonomy Codes
| Specialty |
|---|
| Rehabilitation Counselor |
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