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NPI Code Detail

MEDICARE: KATHLEEN KEANE

MEDICARE: KATHLEEN KEANE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorMH14156FL

General Provider Information

NPI Number : 1407250632
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN KEANE
Provider Business Mailing Address
First Line : 3544 EDGEWATER DR
Second Line :
City : ORLANDO
State : FL
Zip : 32804-2922
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3544 EDGEWATER DR
Second Line :
City : ORLANDO
State : FL
Zip : 32804-2922
Country : US
Telephone Number : 407-291-8009
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2014
Last Update Date : 04/18/2016

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Directions to “ KATHLEEN KEANE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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