Tialavea, Keresoma

Tialavea, Keresoma is an sole proprietor health care provider with primary practice located at 1109 W College Ave Apt 2 , Silver City NM 88061-4100. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as his primary health care specialty. Tialavea, Keresoma can be contacted via phone (415) 730-2365.

Contact Information

Primary practice address
1109 W College Ave Apt 2 Silver City NM 88061-4100
Phone: (415) 730-2365
Fax:
Website:
Map and Directions

Health care specialties

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

Profile Details

NPI number 1487185518
LBN Legal business name Tialavea, Keresoma
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 21st, 2017
Last updated Mar 21st, 2017 - about 7 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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