Individual
ANN KEITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
225 CASA BLANCA AVE, FORT WORTH, TX 76107-7720
(505) 603-2466
Mailing address
225 CASA BLANCA AVE, FORT WORTH, TX 76107-7720
(505) 603-2466
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
57012
TX
Other
Enumeration date
01/29/2020
Last updated
01/29/2020
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