| NPI | 1033504949 |
|---|---|
| Former Name | KELLEY JEAN KEATING |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA17657) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA 22350) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2020-06-29 |