Keller, Jai Bea
Keller, Jai Bea is an sole proprietor health care provider with primary practice located at 86 Boston Ave , Medford MA 02155-3522. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Keller, Jai Bea can be contacted via phone (781) 488-3503.Contact Information
Primary practice address
86 Boston Ave
Medford MA 02155-3522
Phone: (781) 488-3503
Fax: (781) 483-2221
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | #1354 | Massachusetts |
Profile Details
| NPI number | 1285772897 |
|---|---|
| LBN Legal business name | Keller, Jai Bea |
| Credentials | L.M.H.C. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 3rd, 2007 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285772897 | NPPES |
| Massachusetts | Other | #1354 | L.M.H.C. |
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