Individual
MISTI KEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
415 E COMMERCE ST STE 205, GREENVILLE, AL 36037-2328
(334) 371-5848
(334) 371-5849
Mailing address
590 S BOUTWELL RD, FOREST HOME, AL 36030-5327
(334) 371-5848
(334) 371-5849
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
3395
AL
101YP2500X
Professional Counselor
MH 11871
FL
Other
Enumeration date
08/08/2012
Last updated
03/11/2019
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