Individual
ERICA LORRAINE KEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AA
Contact information
Practice address
3830 S CUSHMAN ST, FAIRBANKS, AK 99701-7530
(907) 452-1575
(907) 455-1460
Mailing address
545 WILD HORSE LN, FAIRBANKS, AK 99709-6700
(907) 590-0689
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
246RP1900X
Phlebotomy Technician
Primary
36334
AK
Other
Enumeration date
09/15/2010
Last updated
09/15/2010
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