Individual
MICHAEL KEENAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSUDC
Contact information
Practice address
1223 S 1280 E, SAINT GEORGE, UT 84790-8553
(435) 680-1459
Mailing address
1223 S 1280 E, SAINT GEORGE, UT 84790-8553
(435) 680-1459
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
5649814-6006
UT
Other
Enumeration date
12/06/2018
Last updated
12/06/2018
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