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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083084842 NPPES
Other 1245764927 NA

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