Individual
KATHLEEN B KEANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LP
Contact information
Practice address
1310 HIGHWAY 96 E, WHITE BEAR LAKE, MN 55110-3624
(651) 714-8007
Mailing address
5696 WINDMILL DR, WHITE BEAR LAKE, MN 55110-2284
(651) 714-8007
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3569
MN
Other
Enumeration date
09/14/2006
Last updated
08/03/2007
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