Individual
ANNA KEOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5840 INTERFACE DR STE 400, ANN ARBOR, MI 48103-9176
(734) 627-8001
(734) 433-1989
Mailing address
4765 LORI LN, PINCKNEY, MI 48169-9380
(734) 433-9014
(734) 433-1989
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201009647
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5201009647
STATE LISCENSE NUMBER
MI
Enumeration date
10/18/2016
Last updated
01/24/2017
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