Individual
THERESA KEANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., NPP
Contact information
Practice address
7750 E BROADWAY BLVD STE A100, TUCSON, AZ 85710-3901
(520) 327-1529
Mailing address
97 GRACE WAY, OLIVEBRIDGE, NY 12461-5236
(917) 453-3684
(917) 453-3684
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
011974-1
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F401198
NY
Other
Enumeration date
06/14/2007
Last updated
08/04/2022
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