Provider Demographics
NPI:1710341151
Name:KEENAN, THERESE A (LAC, DIPLOM)
Entity Type:Individual
Prefix:MS
First Name:THERESE
Middle Name:A
Last Name:KEENAN
Suffix:
Gender:F
Credentials:LAC, DIPLOM
Other - Prefix:MS
Other - First Name:TERRY
Other - Middle Name:
Other - Last Name:KEENAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC, DIPLOM
Mailing Address - Street 1:P.O. BOX 417
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866
Mailing Address - Country:US
Mailing Address - Phone:917-603-5222
Mailing Address - Fax:
Practice Address - Street 1:58 HENRY STREET
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866
Practice Address - Country:US
Practice Address - Phone:917-603-5222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist