Provider Demographics
NPI:1881948040
Name:KEEGAN, MEGAN ANN (MS)
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:ANN
Last Name:KEEGAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 SOUTHPARK CIR E
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-5137
Mailing Address - Country:US
Mailing Address - Phone:914-837-2145
Mailing Address - Fax:904-797-5681
Practice Address - Street 1:248 SOUTHPARK CIR E
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-5137
Practice Address - Country:US
Practice Address - Phone:914-837-2145
Practice Address - Fax:904-797-5681
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-08
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health