Provider Demographics
NPI:1104231786
Name:KEERAN, CINDY JEAN (PHD)
Entity type:Individual
Prefix:DR
First Name:CINDY
Middle Name:JEAN
Last Name:KEERAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8830 KEERAN LN NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87122-3782
Mailing Address - Country:US
Mailing Address - Phone:505-249-1374
Mailing Address - Fax:
Practice Address - Street 1:3228 LOS ARBOLES AVE NE
Practice Address - Street 2:BLDG. A. SUITE 200
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-1962
Practice Address - Country:US
Practice Address - Phone:505-249-1374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM103571103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical