Doctor Name: | MARY ANN KEATLEY |
NPI Number: | 1720035306 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | |
Business Practice Address: | 777 29th St Suite 400 Boulder, CO - 803032358 |
Business Phone Number: | 3034443443 |
Business Fax Number: | 9702213730 |
Mailing Address: | Po Box 2086, FORT COLLINS |
State: | CO |
Postal Code: | 805222086 |
Phone Number: | 3034443443 |
Fax Number: | 9702213730 |
NPI Enumeration Date: | 05/28/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
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 |