Individual
MRS. SHADAE KEILIA KLECKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19 DIXWELL ROAD, NEW CITY, NY 10956
(917) 565-5207
Mailing address
19 DIXWELL ROAD, NEW CITY, NY 10956
(917) 565-5207
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
10/03/2019
Last updated
10/03/2019
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