| NPI | 1790468569 |
|---|---|
| Former Name | STACEY ANN KEANE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AL 5267C-S) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2023-08-09 |
| Last Update Date | 2025-01-21 |