Organization
KEELAN DENNIS MFT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEELAN DENNIS MS (MENTAL HEALTH COUNSELOR)
(309) 431-1649
Entity
Organization
Contact information
Practice address
2103 E WASHINGTON ST STE 2G, BLOOMINGTON, IL 61701-4365
(309) 431-1649
Mailing address
2103 E WASHINGTON ST STE 2G, BLOOMINGTON, IL 61701-4365
(309) 431-1649
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578099875
—
OR
Enumeration date
10/11/2018
Last updated
08/05/2021
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