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Individual
KEESHA VINES
Active
Individual
KEESHA VINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.G.P.C.
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LGP6116
MD
Other
Enumeration date
04/28/2016
Last updated
04/28/2016
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