Individual
DR. NICOLE KEENAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
3 HURON CT, MILLER PLACE, NY 11764-2506
(631) 747-0973
Mailing address
3 HURON CT, MILLER PLACE, NY 11764-2506
(631) 747-0973
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
020234
NY
Other
Enumeration date
09/16/2013
Last updated
09/16/2013
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