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Individual

MRS. ERIN KAYE KEENEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
5225 PENTECOST DR, SUITE 26, MODESTO, CA 95356-9284
(209) 576-7280
(209) 576-7275
Mailing address
5225 PENTECOST DR, SUITE 26, MODESTO, CA 95356-9284
(209) 576-7280
(209) 576-7275

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
13753
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13753
CA STATE LICENSE TO PRACTICE SPEECH PATHOLOGY FROM THE CA DEPT. OF CONSMER AFFAI
CA
Enumeration date
04/27/2009
Last updated
04/27/2009
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