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General NPI Number Information
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NPI Number | 1306302138
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Entity Type | Individual
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Provider Name | KEAMOGETSE YASMINE KHUDU CT
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Gender | Female
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Dates
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Enumeration Date | 02/18/2019
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 7100 GRAPHICS WAY STE 3100
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City | LEWIS CENTER
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State | OH
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Zip | 43035-0238
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Country | US
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Telephone | 740-428-0428
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Fax | 740-909-4077
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Provider Business Mailing Address
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Address Line | PO BOX 188
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City | CHILLICOTHEE
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State | OH
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Zip | 45601-0188
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Country | US
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Telephone | 740-773-4366
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Fax | 740-775-7855
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C.2507649
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License Number State | OH
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