Healthcare Provider Details

I. General information

NPI: 1427028901
Provider Name (Legal Business Name): JOSEPH THOMAS KEENAN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97 MAIN ST
LANCASTER NH
03584-3027
US

IV. Provider business mailing address

PO BOX 269
LANCASTER NH
03584-0269
US

V. Phone/Fax

Practice location:
  • Phone: 603-788-2288
  • Fax: 603-788-5027
Mailing address:
  • Phone: 603-788-2288
  • Fax: 603-788-5027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number746
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: