Provider Demographics
NPI:1790264513
Name:KEENAN, LORENE TOHMY
Entity Type:Individual
Prefix:
First Name:LORENE
Middle Name:TOHMY
Last Name:KEENAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 NOWAK CT APT C
Mailing Address - Street 2:
Mailing Address - City:FORT JOHNSON
Mailing Address - State:LA
Mailing Address - Zip Code:71459-3651
Mailing Address - Country:US
Mailing Address - Phone:703-980-4720
Mailing Address - Fax:
Practice Address - Street 1:6101 NOWAK CT APT C
Practice Address - Street 2:
Practice Address - City:FORT JOHNSON
Practice Address - State:LA
Practice Address - Zip Code:71459-3651
Practice Address - Country:US
Practice Address - Phone:703-980-4720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst