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Individual

GEORGIA R KEENAN

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
212 S 11TH STREET, LACROSSE, WI 54601
(608) 791-9555
(608) 791-9432
Mailing address
700 WEST AVENUE SOUTH, ATTN PHYSICIAN SERVICES, LACROSSE, WI 54601
(608) 791-4156
(608) 791-9898

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1700
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39648500
WI
Enumeration date
06/03/2006
Last updated
07/08/2007
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