Most Relevant Information
Provider Data
| NPI Number: | 1003699208 |
| Provider Name: | KEANU KALANI LAPOT BA |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/14/2023 |
| Last Updated: | 08/14/2023 |
Provider Practice Location
30 MEDICAL CENTER BLVD
CHESTER
PA
190133955
Practice Location Phone/Fax
| Phone: | 8564044044 |
| Fax: |
Provider Mailing Location
424 LINCOLN RD
PILESGROVE
NJ
080983227
Provider Mailing Phone/Fax
| Phone: | 8564044044 |
| Fax: |