Individual
KEETON BUFFUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
515 SIMPSON DR, WINONA, MS 38967-3009
(769) 233-7154
Mailing address
105 BAY MEADOWS DR, STARKVILLE, MS 39759-6612
(601) 405-9011
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-323976
MS
Other
Enumeration date
07/17/2024
Last updated
07/17/2024
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