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General NPI Number Information
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NPI Number | 1316687247
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Entity Type | Organization
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Legal Business Name | BLAIR KEENER LCSW LLC
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Dates
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Enumeration Date | 03/30/2022
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Last Update Date | 03/30/2022
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Provider Practice Location Address
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Address Line | 5702 OLOHENA RD
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City | KAPAA
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State | HI
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Zip | 96746-8808
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Country | US
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Telephone | 808-651-7465
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1923
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City | KAPAA
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State | HI
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Zip | 96746-5923
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Country | US
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Telephone | 808-651-7465
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Fax |
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Authorized Official
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Title or Position | OWNER / SOLE MEMBER
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Name | BLAIR KEENER
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Credential | LCSW
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Telephone | 808-651-7465
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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