Provider Demographics
NPI:1568981009
Name:KEOSHIAN, MARGEE
Entity Type:Individual
Prefix:
First Name:MARGEE
Middle Name:
Last Name:KEOSHIAN
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 1:810 2ND ST
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-4112
Mailing Address - Country:US
Mailing Address - Phone:989-860-6570
Mailing Address - Fax:
Practice Address - Street 1:8283 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-2032
Practice Address - Country:US
Practice Address - Phone:810-321-3001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-15
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst