Individual
JEANA SUSAN KEENER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17 CYPRESS DR, FAIRMONT, WV 26554-8990
(304) 435-8796
Mailing address
17 CYPRESS DR, FAIRMONT, WV 26554-8990
(304) 435-8796
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
WV
Other
Enumeration date
09/06/2024
Last updated
09/06/2024
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