Individual
KEISSY MARGARITA REYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 WHITE BIRCH LN, BLANDON, PA 19510-9526
(646) 549-2913
Mailing address
400 WHITE BIRCH LN, BLANDON, PA 19510-9526
(646) 549-2913
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103459454
—
PA
Enumeration date
05/15/2018
Last updated
05/15/2018
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