Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 75343 | TX |
NPI | 1073086484 |
---|---|
Provider Name | Cheri Trahan Keene |
First Address | San Antonio, TX 78209-6549 |
Second Address | San Antonio, TX 78209-6549 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2019 |
Last Update Date | 08/01/2019 |