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NPI Code Detail

MEDICARE: KASSIDEE TABOR KEEFE MS

MEDICARE: KASSIDEE TABOR KEEFE MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1023888492
Entity Type Code : Individual
Provider Name (Legal Business Name) : KASSIDEE TABOR KEEFE MS
Provider Business Mailing Address
First Line : PO BOX 724
Second Line :
City : NEWPORT
State : VT
Zip : 05855-0724
Country : US
Telephone Number : 802-334-6744
Fax Number :
Provider Business Practice Location Address
First Line : 181 CRAWFORD RD
Second Line :
City : NEWPORT
State : VT
Zip : 05855-6405
Country : US
Telephone Number : 802-334-6744
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2024
Last Update Date : 01/05/2024

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Directions to “ KASSIDEE TABOR KEEFE MS” Practice Location

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