Provider Demographics
NPI:1669229860
Name:ARTHUR, KECIA SONITA
Entity type:Individual
Prefix:
First Name:KECIA
Middle Name:SONITA
Last Name:ARTHUR
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 1:1202 BOONE HILL RD APT D
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-2400
Mailing Address - Country:US
Mailing Address - Phone:843-259-8521
Mailing Address - Fax:
Practice Address - Street 1:1202 BOONE HILL RD APT D
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-2400
Practice Address - Country:US
Practice Address - Phone:843-259-8521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-04
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician