Provider Demographics
NPI:1578974192
Name:KEESE-HAMM, NATALIE ANNE (LMFT3073)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:ANNE
Last Name:KEESE-HAMM
Suffix:
Gender:F
Credentials:LMFT3073
Other - Prefix:MRS
Other - First Name:NATALIE
Other - Middle Name:ANNE
Other - Last Name:KEESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICENSED MARRIAGE AN
Mailing Address - Street 1:423 MILITARY DR
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2138
Mailing Address - Country:US
Mailing Address - Phone:208-699-3477
Mailing Address - Fax:
Practice Address - Street 1:423 MILITARY DR
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2138
Practice Address - Country:US
Practice Address - Phone:208-699-3477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-16
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMFT3073106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist