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Individual
MRS. SUSAN M KEOGH
Active
Individual
MRS. SUSAN M KEOGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180001161
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101694
HEALTH ALLIANCE
—
01
—
202808
MHN
—
01
—
5723204
BCBS
—
Enumeration date
11/02/2006
Last updated
06/19/2012
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