Individual
EITHNE KEENAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
261 UNION ST, SUITE 218, NEW BEDFORD, MA 02740-5949
(508) 996-2390
Mailing address
261 UNION ST, SUITE 218, NEW BEDFORD, MA 02740-5949
(508) 996-2390
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2723
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000024187
BMC HEALTHNET PLAN
MA
05
—
0513296
—
MA
01
—
W02885
BLUE CROSS BLUE SHIELD MA
MA
Enumeration date
11/14/2006
Last updated
07/08/2007
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