Doctor Name: | STEPHANIE KEUNE |
NPI Number: | 1003261777 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 2013043231 |
Business Practice Address: | 2120 Parkway Drive Bridgeway Behavioral Health Saint Peters, MO - 633766459 |
Business Phone Number: | 6362241163 |
Business Fax Number: | 6369251443 |
Mailing Address: | 2120 Parkway Drive, Bridgeway Behavioral Health ST. PETERS |
State: | MO |
Postal Code: | 63376 |
Phone Number: | 6362241163 |
Fax Number: | 6369251443 |
NPI Enumeration Date: | 04/29/2016 |
NPI Last Update Date: | 04/29/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2013043231 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |