Provider Demographics
NPI:1508618570
Name:STARNES, KEILANI ALICIA
Entity Type:Individual
Prefix:
First Name:KEILANI
Middle Name:ALICIA
Last Name:STARNES
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 1:3379 SUMMERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-4647
Mailing Address - Country:US
Mailing Address - Phone:931-367-7777
Mailing Address - Fax:
Practice Address - Street 1:3379 SUMMERFIELD DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37042-4647
Practice Address - Country:US
Practice Address - Phone:931-367-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician