Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XG0600X | Occupational Therapist - Gerontology | 2648 | NH |
Y | 225XM0800X | Mental Health | 072.0107297 | VT |
NPI | 1841871670 |
---|---|
Provider Name | Mrs. Tamasin B. Kekic |
First Address | Chester, VT 05143 |
Second Address | Chester, VT 05143 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2021 |
Last Update Date | 14/04/2021 |