Individual
ABIGAIL MARIE KEENUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
32 MILLBRANCH RD STE 40, HATTIESBURG, MS 39402-1673
(601) 255-5264
Mailing address
216 WESTOVER DR APT 8G, HATTIESBURG, MS 39402-1340
(228) 355-8702
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-167715
MS
Other
Enumeration date
06/03/2021
Last updated
06/03/2021
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