Provider Demographics
NPI:1336644186
Name:KEIM, KAHLIE MEARA
Entity Type:Individual
Prefix:MS
First Name:KAHLIE
Middle Name:MEARA
Last Name:KEIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4415 NW 41ST PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-4515
Mailing Address - Country:US
Mailing Address - Phone:352-262-4485
Mailing Address - Fax:
Practice Address - Street 1:4415 NW 41ST PL
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-4515
Practice Address - Country:US
Practice Address - Phone:352-262-4485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist