Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 1534 | KY |
Y | 103TC0700X | Clinical Psychologist | 1534 | KY |
NPI | 1912201658 |
---|---|
Provider Name | Dr. Kristy Marie Keefe |
First Address | Gray, KY 40734-6656 |
Second Address | Gray, KY 40734-6656 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2011 |
Last Update Date | 10/01/2011 |