Individual
KIMBERLY BETH KEANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3104 W 118TH ST, MERRIONETTE PARK, IL 60803-3002
(708) 712-8902
Mailing address
3104 W 118TH ST, MERRIONETTE PARK, IL 60803-3002
(708) 712-8902
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
07/04/2023
Last updated
07/04/2023
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