Individual
LYDIA KEISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
204 TEAYS VILLA, SCOTT DEPOT, WV 25560-9418
(304) 382-6691
Mailing address
204 TEAYS VILLA, SCOTT DEPOT, WV 25560-9418
(304) 382-6691
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
09/25/2024
Last updated
09/25/2024
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