Individual
AMANDA J O'KEEFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
2351 N 62ND ST, WAUWATOSA, WI 53213-1509
(414) 258-0612
Mailing address
2351 N 62ND ST, WAUWATOSA, WI 53213-1509
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2665-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42568700
—
WI
Enumeration date
04/04/2008
Last updated
04/04/2008
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