Doctor Name: | JENNIFER FRYE KEEFE |
NPI Number: | 1033453030 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. |
License Number: | 1582-226 |
Business Practice Address: | 166 E Geneva Sq Lake Geneva, WI - 531479694 |
Business Phone Number: | 2622490830 |
Business Fax Number: | 2622490835 |
Mailing Address: | 166 E Geneva Sq, LAKE GENEVA |
State: | WI |
Postal Code: | 531479694 |
Phone Number: | 2622490830 |
Fax Number: | 2622490835 |
NPI Enumeration Date: | 11/15/2012 |
NPI Last Update Date: | 11/15/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 1582-226 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |