Provider Demographics
NPI:1467251439
Name:SAUBER, KELLEY BETH (MS, MHP)
Entity type:Individual
Prefix:MRS
First Name:KELLEY
Middle Name:BETH
Last Name:SAUBER
Suffix:
Gender:
Credentials:MS, MHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4474 PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23518-1710
Mailing Address - Country:US
Mailing Address - Phone:757-272-2583
Mailing Address - Fax:
Practice Address - Street 1:425 W WASHINGTON ST STE 4
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-5320
Practice Address - Country:US
Practice Address - Phone:757-809-5376
Practice Address - Fax:757-401-6912
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA249145171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach