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NPI Code Detail

MEDICARE: MS. CORETTA MONIQUE KEA

MEDICARE:  MS. CORETTA MONIQUE KEA
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
1104100000XSocial Worker12145SC

General Provider Information

NPI Number : 1225197924
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CORETTA MONIQUE KEA
Provider Business Mailing Address
First Line : 521 GIBSON RD
Second Line :
City : LEXINGTON
State : SC
Zip : 29072-2551
Country : US
Telephone Number : 803-951-3490
Fax Number :
Provider Business Practice Location Address
First Line : 521 GIBSON RD
Second Line :
City : LEXINGTON
State : SC
Zip : 29072-2551
Country : US
Telephone Number : 803-951-3490
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2006
Last Update Date : 02/05/2026

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Directions to “ MS. CORETTA MONIQUE KEA ” Practice Location

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