| Doctor Name: | KEESHA L. PETERSON |
| NPI Number: | 1417147760 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M. S. CCC-SLP |
| License Number: | 22003291A |
| Business Practice Address: | 1418 College Drive Physical Medicine Department Mount Carmel, IL - 62863 |
| Business Phone Number: | 6182636343 |
| Business Fax Number: | 6182636477 |
| Mailing Address: | 1418 College Dr, MOUNT CARMEL |
| State: | IL |
| Postal Code: | 628632638 |
| Phone Number: | 6182636343 |
| Fax Number: | 6182636477 |
| NPI Enumeration Date: | 08/01/2007 |
| NPI Last Update Date: | 07/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 22003291A |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IN |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |