Willis, Kameshia S
Willis, Kameshia S is an sole proprietor health care provider with primary practice located at 145 E Edgewood Dr , Lakeland FL 33803-4014. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Willis, Kameshia S can be contacted via phone (863) 777-0134.Contact Information
Primary practice address
145 E Edgewood Dr
Lakeland FL 33803-4014
Phone: (863) 777-0134
Fax: (864) 644-9590
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavior Technician | 106S00000X | 19-82907 | Florida |
Profile Details
| NPI number | 1407397979 |
|---|---|
| LBN Legal business name | Willis, Kameshia S |
| Credentials | RBT |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 16th, 2017 |
| Last updated | Mar 25th, 2022 - about 4 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 | 1407397979 | NPPES |
| Florida | MEDICAID | 247200000X |
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