Provider Demographics
NPI:1609167865
Name:KEEHN, DEBRA (MSW)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:
Last Name:KEEHN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:DEBRA
Other - Middle Name:
Other - Last Name:KEEHN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:342 S ASHLEY ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-1351
Mailing Address - Country:US
Mailing Address - Phone:734-761-7204
Mailing Address - Fax:734-761-3933
Practice Address - Street 1:342 S ASHLEY ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-1351
Practice Address - Country:US
Practice Address - Phone:734-761-7204
Practice Address - Fax:734-761-3933
Is Sole Proprietor?:No
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010645721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical