Individual
MARIAH KEATHLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
201 W BROADWAY STE 2F, COLUMBIA, MO 65203-3842
(573) 214-0436
(573) 442-0606
Mailing address
201 W BROADWAY STE 2F, COLUMBIA, MO 65203-3842
(573) 214-0436
(573) 442-0606
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
201904254
MO
Other
Enumeration date
11/08/2019
Last updated
11/08/2019
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