Luster, Keenan
Luster, Keenan is an sole proprietor health care provider with primary practice located at 146 Timber Creek Dr Ste 101 , Cordova TN 38018-4396. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Luster, Keenan can be contacted via phone (901) 249-7838.Contact Information
Primary practice address
146 Timber Creek Dr Ste 101
Cordova TN 38018-4396
Phone: (901) 249-7838
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavior Technician | 106S00000X | Tennessee |
Profile Details
| NPI number | 1083084842 |
|---|---|
| LBN Legal business name | Luster, Keenan |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 5th, 2015 |
| Last updated | Jan 2nd, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083084842 | NPPES |
| Other | 1245764927 | NA |
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