| Doctor Name: | DR. JERALDINE S KEANE-DREYER |
| NPI Number: | 1114024296 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | PSY625 |
| Business Practice Address: | 32 Tandberg Trl Suite 4 Windham, ME - 040626417 |
| Business Phone Number: | 2076559008 |
| Business Fax Number: | 2076559005 |
| Mailing Address: | Po Box 96, RAYMOND |
| State: | ME |
| Postal Code: | 040710096 |
| Phone Number: | 2076559008 |
| Fax Number: | 2076559005 |
| NPI Enumeration Date: | 09/20/2006 |
| NPI Last Update Date: | 08/15/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | PSY625 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |