Doctor Name: | KEYNARD EDOUARD |
NPI Number: | 1013247287 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.S. |
License Number: | 27774700 |
Business Practice Address: | 1219 Rainer Rd Brookhaven, PA - 190151935 |
Business Phone Number: | 6106133331 |
Business Fax Number: | |
Mailing Address: | 1219 Rainer Rd, BROOKHAVEN |
State: | PA |
Postal Code: | 190151935 |
Phone Number: | 6106133331 |
Fax Number: | |
NPI Enumeration Date: | 01/11/2010 |
NPI Last Update Date: | 01/11/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 27774700 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |