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General NPI Number Information
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NPI Number | 1134899107
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Entity Type | Organization
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Legal Business Name | KEY BEHAVIOR SOLUTIONS CONSULTING GROUP (KBS)
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Dates
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Enumeration Date | 09/20/2021
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Last Update Date | 09/20/2021
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Provider Practice Location Address
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Address Line | 103 SCOTT STREET
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City | SHAW
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State | MS
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Zip | 38773-3877
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Country | US
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Telephone | 662-374-9794
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 274
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City | SHAW
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State | MS
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Zip | 38773-0274
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Country | US
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Telephone | 662-374-9794
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Fax |
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Authorized Official
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Title or Position | CEO/FOUNDER
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Name | MS. CARMALETA L. SHAW
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Credential |
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Telephone | 662-374-9794
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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