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General NPI Number Information
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NPI Number | 1346579745
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Entity Type | Organization
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Legal Business Name | KATHLEEN J. KEENAN, PH.D., L.L.C.
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Dates
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Enumeration Date | 12/14/2009
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Last Update Date | 09/13/2021
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Provider Practice Location Address
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Address Line | 10965 GRANADA LANE SUITE 101
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City | OVERLAND PARK
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State | KS
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Zip | 66211-1412
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Country | US
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Telephone | 913-777-6665
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Fax | 913-345-0090
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Provider Business Mailing Address
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Address Line | 10965 GRANADA LANE SUITE 101
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City | OVERLAND PARK
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State | KS
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Zip | 66211-1412
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Country | US
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Telephone | 913-777-6665
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Fax | 913-345-0090
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MRS. KATHLEEN J KEENAN
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Credential | PH.D.
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Telephone | 913-648-1870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 994
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License Number State | KS
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