Provider Demographics
NPI:1891976791
Name:ANDERSON-KEENE, CYNTHIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:
Last Name:ANDERSON-KEENE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:KEENE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:5483 WALDEN BAY DR
Mailing Address - Street 2:
Mailing Address - City:WAUNAKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53597-9099
Mailing Address - Country:US
Mailing Address - Phone:608-575-2483
Mailing Address - Fax:
Practice Address - Street 1:3016 WOODLAND TRL
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-1900
Practice Address - Country:US
Practice Address - Phone:608-575-2483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-19
Last Update Date:2022-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2453-057103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist