Individual
MRS. SHANA MARLENE KEYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4010 O'FERRAL STREET, SUITE 110, HATTIESBURG, MS 39402
(601) 201-7933
(601) 469-9927
Mailing address
1832 SCR 84-A, BAY SPRING, MS 39422
(601) 201-7933
(601) 469-9927
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C2333
MS
106H00000X
Marriage & Family Therapist
T0308
MS
Other
Enumeration date
10/14/2010
Last updated
10/14/2010
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