Provider Demographics
NPI:1801653977
Name:KEHS, KATHERINE VANESSA (MSED)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:VANESSA
Last Name:KEHS
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 BANNER AVE APT 6E
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-5263
Mailing Address - Country:US
Mailing Address - Phone:718-913-6050
Mailing Address - Fax:
Practice Address - Street 1:1125 BANNER AVE APT 6E
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-5263
Practice Address - Country:US
Practice Address - Phone:718-913-6050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1789764241174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist