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Individual

MS. KEITHA MAUREEN AUSTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW, BCD

Contact information

Practice address
12725 MCMANUS BLVD, SUITE 2G, NEWPORT NEWS, VA 23602-4402
(757) 874-1676
(757) 874-2226
Mailing address
121 KEITH RD, NEWPORT NEWS, VA 23606-1109
(757) 223-1020

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904002555
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1417954686
VA
Enumeration date
07/03/2005
Last updated
01/18/2008
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