Provider Demographics
NPI:1780915454
Name:KEEFE, CAITLIN JANE (MS)
Entity type:Individual
Prefix:MS
First Name:CAITLIN
Middle Name:JANE
Last Name:KEEFE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 W SOUTHERN AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85120-7456
Mailing Address - Country:US
Mailing Address - Phone:480-982-1110
Mailing Address - Fax:480-983-9467
Practice Address - Street 1:1575 W SOUTHERN AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85120-7456
Practice Address - Country:US
Practice Address - Phone:480-982-1110
Practice Address - Fax:480-983-9467
Is Sole Proprietor?:No
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool