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NPI Code Detail

MEDICARE: KEITH HUFFMAN

MEDICARE: KEITH HUFFMAN
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
1101YP2500XProfessional Counselor0701008650VA
2101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1851942734
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEITH HUFFMAN
Provider Business Mailing Address
First Line : 1212 COMMONWEALTH CIR
Second Line :
City : FOREST
State : VA
Zip : 24551-2464
Country : US
Telephone Number : 434-229-3216
Fax Number :
Provider Business Practice Location Address
First Line : 3433 BRAMBLETON AVE STE 201A
Second Line :
City : ROANOKE
State : VA
Zip : 24018-6527
Country : US
Telephone Number : 540-266-7550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2019
Last Update Date : 09/23/2019

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Directions to “ KEITH HUFFMAN ” Practice Location

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