Individual
KAISHA KEITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC , LCPC
Contact information
Practice address
14100 MAGELLAN PLZ, 14100 MAGELLAN PLAZA, MARYLAND HEIGHTS, MO 63043-4644
(800) 462-1812
Mailing address
14100 MAGELLAN PLZ, MARYLAND HEIGHTS, MO 63043-4644
(800) 462-1812
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701004578
VA
101YP2500X
Professional Counselor
LC3024
MD
Other
Enumeration date
02/04/2009
Last updated
03/31/2015
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