Individual
CRAIG D KEENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
425 BROADWAY ST, PADUCAH, KY 42001-0713
(270) 442-7121
Mailing address
425 BROADWAY, PADUCAH, KY 42001
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3697
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
710028107
—
KY
Enumeration date
01/12/2007
Last updated
08/17/2023
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