Provider Demographics
NPI:1871279752
Name:CINTRON KANE, KEYSHA JOAN
Entity type:Individual
Prefix:
First Name:KEYSHA
Middle Name:JOAN
Last Name:CINTRON KANE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URBA ALTOS DE FLORIDA 205 CALLE JESUS HERNANDEZ
Mailing Address - Street 2:
Mailing Address - City:FLORIDA
Mailing Address - State:PR
Mailing Address - Zip Code:00650
Mailing Address - Country:US
Mailing Address - Phone:939-717-1459
Mailing Address - Fax:
Practice Address - Street 1:URBA. ALTOS DE FLORIDA D6 CALLE JESUS HERNANDEZ
Practice Address - Street 2:
Practice Address - City:FLORIDA
Practice Address - State:PR
Practice Address - Zip Code:00650
Practice Address - Country:US
Practice Address - Phone:939-717-1459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR65491081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty