Provider Demographics
NPI:1184859555
Name:TOWNSEL, KESHA SAQUORIA (TSHH, MS, SDL)
Entity type:Individual
Prefix:MRS
First Name:KESHA
Middle Name:SAQUORIA
Last Name:TOWNSEL
Suffix:
Gender:F
Credentials:TSHH, MS, SDL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 WYTHE PL
Mailing Address - Street 2:4A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-6981
Mailing Address - Country:US
Mailing Address - Phone:718-384-6598
Mailing Address - Fax:718-384-1858
Practice Address - Street 1:626 WYTHE PL
Practice Address - Street 2:4A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-6981
Practice Address - Country:US
Practice Address - Phone:718-384-6598
Practice Address - Fax:718-384-1858
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY589339051252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency