Individual
TANESHA KEETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
6501 GREGORY ST, MOSS POINT, MS 39563-4725
(228) 218-1605
Mailing address
6501 GREGORY ST, MOSS POINT, MS 39563-4725
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
113110
TX
225X00000X
Occupational Therapist
2617
AL
225X00000X
Occupational Therapist
Primary
OT004612
GA
225X00000X
Occupational Therapist
OT13437
FL
Other
Enumeration date
01/13/2014
Last updated
01/13/2014
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