Provider Information for 1326345778
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Ms. KATHY SHARP KEITH LPC
Other Names:Other Name:Mrs. KATHY LOU EDGE LPCSex: Female
NPI: 1326345778
Last Updated: 2011-02-22
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1326345778 | ||||||||
| Enumeration Date | 2011-02-22 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 21075 FOREST GROVE DR CHANDLER, TX 75758-8225 United States Phone: 903-849-5297 | Fax:903-723-8252 | ||||||||
| Primary Practice Address | 207 W PALESTINE AVE PALESTINE, TX 75801-7531 United States Phone: 903-849-5297 | Fax:903-723-8252 | ||||||||
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