Individual
OLIVIA RAFFAELLA-ANNA KEENAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
21401 ALLEN RD, WOODHAVEN, MI 48183-1665
(734) 675-0835
(734) 675-0873
Mailing address
21401 ALLEN RD, WOODHAVEN, MI 48183-1665
(734) 675-0835
(734) 675-0873
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
5601009409
MI
363AM0700X
Medical Physician Assistant
Primary
5601009409
MI
Other
Enumeration date
08/14/2019
Last updated
01/14/2025
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