Individual
DR. HOMER DALE KEETON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
407 CHURCH ST NE STE I, VIENNA, VA 22180-4737
(703) 356-1330
(703) 938-1373
Mailing address
407 CHURCH ST NE STE I, VIENNA, VA 22180-4737
(703) 356-1330
(703) 938-1373
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701000638
VA
Other
Enumeration date
08/02/2006
Last updated
07/08/2007
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