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Individual

MRS. KEANE GREGORY HALE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A. CCC-SLP

Contact information

Practice address
106 N FRONT AVE, PRESTONSBURG, KY 41653-7832
(606) 886-3891
(606) 886-9081
Mailing address
PO BOX 61, BLUE RIVER, KY 41607-0061
(606) 886-8740

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0627
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GN107
KY
Enumeration date
04/11/2007
Last updated
07/09/2007
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