Individual
KEISHA ROBINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LBS
Contact information
Practice address
6852 REGENT ST, PHILADELPHIA, PA 19142-1213
(267) 972-3098
Mailing address
6852 REGENT ST, PHILADELPHIA, PA 19142-1213
(267) 972-3098
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
BH003484
PA
Other
Enumeration date
02/12/2019
Last updated
02/12/2019
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