Individual
MRS. JENNY LYNNE KEENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
103 EL NATHAN DRIVE, MARBLE HILL, MO 63764-8342
(573) 238-1027
(573) 238-1171
Mailing address
402 S SILVER SPRINGS RD, CAPE GIRARDEAU, MO 63703-7536
(573) 334-1100
(573) 651-4345
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
2015037534
MO
1041C0700X
Clinical Social Worker
Primary
218042356
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490050878
—
MO
Enumeration date
01/31/2018
Last updated
09/12/2022
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