Individual
STEPHANIE KEENAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
8308 TIMBER BROOK LN, SPRINGFIELD, VA 22153-2254
(330) 679-8779
Mailing address
2653 WAITES DR, GROVETOWN, GA 30813-5955
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202008863
VA
235Z00000X
Speech-Language Pathologist
SLP008723
GA
235Z00000X
Speech-Language Pathologist
SP09386
OH
Other
Enumeration date
01/02/2018
Last updated
05/03/2018
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