Chambliss, Keturah

Chambliss, Keturah is an sole proprietor health care provider with primary practice located at 10850 S Us Highway 1 Ste 2 , Port St Lucie FL 34952-6407. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Behavior Technician. Behavioral Health & Social Service Providers / Behavior Technician is her primary health care specialty. Chambliss, Keturah can be contacted via phone (772) 463-0444.

Contact Information

Primary practice address
10850 S Us Highway 1 Ste 2 Port St Lucie FL 34952-6407
Phone: (772) 463-0444
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X

Profile Details

NPI number 1467719518
LBN Legal business name Chambliss, Keturah
Credentials MS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 13th, 2012
Last updated Mar 17th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467719518 NPPES
Florida MEDICAID 019183800

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