Kory Keefauver
Counselor in Santa Rosa, CA. Individual provider (NPI-1).
NPI number1154863363
StatusActive
Last updated in NPPESFeb 15, 2017
Details
- NPI
- 1154863363
- Entity type
- Individual (NPI-1)
- Name
- Kory Keefauver
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 7, 2016
- Last updated
- Feb 15, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | – | – | Yes |
Practice location
2447 Summerfield RdSanta Rosa, CA 95405-7815
Phone 707-544-3299
Mailing address
2447 Summerfield RdSanta Rosa, CA 95405
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