Individual
KEYANNA AZARIA JEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1310 HIDDEN RDG APT 2093, IRVING, TX 75038-8233
(407) 985-0614
Mailing address
1310 HIDDEN RDG APT 2093, IRVING, TX 75038-8233
(407) 985-0614
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/04/2024
Last updated
01/04/2024
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