Individual
MS. ANNA NICOLE MCKEOWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ASW
Contact information
Practice address
COLONY DR, SAN LUIS OBISPO, CA 93401
(732) 429-3572
Mailing address
1035 BUCHON ST APT B, SAN LUIS OBISPO, CA 93401-4021
(732) 429-3572
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
119350
CA
Other
Enumeration date
12/15/2023
Last updated
12/15/2023
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