Individual
NICOLE ANNE KEEGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
1221 PIERCE STREET, SIOUX CITY, IA 51105
(712) 255-0204
Mailing address
1221 PIERCE STREET, SIOUX CITY, IA 51105
(712) 255-0204
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11146
IA
Other
Enumeration date
07/27/2015
Last updated
07/27/2015
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