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General NPI Number Information
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NPI Number | 1518012707
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Entity Type | Organization
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Legal Business Name | BARBARA KEEZELL, PC
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1415 BEACON ST ROOM 302
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City | BROOKLINE
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State | MA
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Zip | 02446-4816
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Country | US
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Telephone | 617-730-9400
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Fax |
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Provider Business Mailing Address
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Address Line | 1415 BEACON ST ROOM 302
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City | BROOKLINE
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State | MA
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Zip | 02446-4816
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Country | US
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Telephone | 617-730-9400
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. BARBARA KEEZELL
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Credential | LICSW
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Telephone | 617-730-9400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 105296
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License Number State | MA
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