Doctor Name: | KEESHA VINES |
NPI Number: | 1992150841 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.G.P.C. |
License Number: | LGP6116 |
Business Practice Address: | 30007 Business Center Dr Charlotte Hall, MD - 206223101 |
Business Phone Number: | 3019971300 |
Business Fax Number: | |
Mailing Address: | 6716 Flying Squirrel Ct, WALDORF |
State: | MD |
Postal Code: | 206034332 |
Phone Number: | 2146363761 |
Fax Number: | |
NPI Enumeration Date: | 04/28/2016 |
NPI Last Update Date: | 04/28/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | LGP6116 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |