Individual
MISS MELISSA KEEGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
141 CITATION WAY, HAILEY, ID 83333-5103
(208) 731-8233
Mailing address
PO BOX 2141, SUN VALLEY, ID 83353-2141
(208) 731-8233
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-31372
ID
Other
Enumeration date
07/25/2013
Last updated
07/25/2013
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