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General NPI Number Information
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NPI Number | 1528361979
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Entity Type | Individual
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Provider Name | KEISA MAKEEBA RODNEY RSW
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Gender | Female
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Dates
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Enumeration Date | 12/07/2010
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Last Update Date | 12/07/2010
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Provider Practice Location Address
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Address Line | 2400 EDENBORN AVE
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City | METAIRIE
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State | LA
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Zip | 70001-1817
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Country | US
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Telephone | 504-838-5275
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Fax | 504-838-5591
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Provider Business Mailing Address
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Address Line | 3201 ANGELIQUE DR
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City | VIOLET
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State | LA
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Zip | 70092-2851
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Country | US
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Telephone | 504-682-9301
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Fax | 504-682-9301
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 9571
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License Number State | LA
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