Provider Demographics
NPI:1013729862
Name:KEITHAHN, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:KEITHAHN
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 1:9191 JAMES BLVD
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-9617
Mailing Address - Country:US
Mailing Address - Phone:907-723-3591
Mailing Address - Fax:
Practice Address - Street 1:9191 JAMES BLVD
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-9617
Practice Address - Country:US
Practice Address - Phone:907-723-3591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor