| NPI | 1346012937 |
|---|---|
| Former Name | SUSAN MACIE KEENAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11029294) |
| Enumeration Date | 2023-10-26 |
| Last Update Date | 2024-04-12 |