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General NPI Number Information
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NPI Number | 1982258794
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Entity Type | Individual
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Provider Name | LEIGHTON KEEN
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Gender | Female
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Dates
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Enumeration Date | 07/30/2019
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Last Update Date | 05/19/2023
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Provider Practice Location Address
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Address Line | 5507 RANCH DR STE 209B
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City | LITTLE ROCK
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State | AR
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Zip | 72223-0043
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Country | US
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Telephone | 501-214-6136
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Fax |
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Provider Business Mailing Address
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Address Line | 1616 WESTGATE CIR
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City | BRENTWOOD
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State | TN
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Zip | 37027-8019
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Country | US
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Telephone | 615-488-7105
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Fax |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1445
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License Number State | TN
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