Individual
MS. VANESSA AERIN KEITHLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
50 DONALD B DEAN DR # B, SOUTH PORTLAND, ME 04106-3373
(207) 274-2528
Mailing address
996 ROYAL MARCO WAY, MARCO ISLAND, FL 34145-1829
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/26/2024
Last updated
12/26/2024
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