Provider Demographics
NPI:1326880428
Name:KEENAN, HEATHER ELIZABETH
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:ELIZABETH
Last Name:KEENAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 W FERNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TORONTO
Mailing Address - State:OH
Mailing Address - Zip Code:43964-1926
Mailing Address - Country:US
Mailing Address - Phone:740-804-1025
Mailing Address - Fax:
Practice Address - Street 1:721 W FERNWOOD DR
Practice Address - Street 2:
Practice Address - City:TORONTO
Practice Address - State:OH
Practice Address - Zip Code:43964-1926
Practice Address - Country:US
Practice Address - Phone:740-804-1025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator