Individual
MS. MARCHELLE THERESA KEENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1203 MAPLE ST, GREENSBORO, NC 27405-6910
(336) 641-6611
(336) 641-6693
Mailing address
1203 MAPLE ST, GREENSBORO, NC 27405-6910
(336) 641-6611
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
566000305
—
NC
Enumeration date
02/16/2009
Last updated
02/16/2009
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