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General NPI Number Information
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NPI Number | 1528094273
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Entity Type | Individual
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Provider Name | DEIDRA DICKEY KEENER LPC
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Gender | Female
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Dates
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Enumeration Date | 06/24/2006
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Last Update Date | 03/01/2019
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Provider Practice Location Address
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Address Line | 3536 VANN ROAD, SUITE A-6
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City | BIRMINGHAM
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State | AL
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Zip | 35235
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Country | US
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Telephone | 205-529-9894
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Fax | 205-529-9894
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Provider Business Mailing Address
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Address Line | 3215 TRACE WAY
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City | TRUSSVILLE
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State | AL
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Zip | 35173
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Country | US
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Telephone | 205-706-7295
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Fax | 205-510-2790
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | #2456
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License Number State | AL
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