KEITHA LATRICE BROYLES
NPI 1649792128
Counselor - Mental Health in Millington, TN
Active since July 17, 2017
About Keitha Latrice Broyles NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KEITHA LATRICE BROYLES (NPI 1649792128) is an individual mental health provider in Millington, Tennessee and active in the NPI registry since July 2017.
NPPES Registry Identity
NPI1649792128
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameKEITHA LATRICE BROYLES
Location Address5281 NAVY RDMillington, TN 38053-2535
Mailing Address4375 Highway 51 N Apt 25-103Horn Lake, MS 38637-8720 · (901) 371-7185
Phone(901) 873-0305
Sole ProprietorYes
Enumeration DateJuly 17, 2017
✔ NPI 1649792128 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
5281 NAVY RD, Millington, TN 38053
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Pharmacy (Long Term Care Pharmacy)
5281 NAVY RD
MILLINGTON, TN 38053
MILLINGTON, TN 38053
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1649792128, enumerated as an "individual" on July 17, 2017.
The provider is located at 5281 NAVY RD MILLINGTON, TN 38053 and the phone number is (901) 873-0305.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.
