Individual
JACOB KEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
295 CHIPETA WAY, WILLIAMS BUILDING, RM 1N490, SALT LAKE CITY, UT 84108
(801) 213-3751
Mailing address
295 CHIPETA WAY, WILLIAMS BUILDING, RM 1N490, SALT LAKE CITY, UT 84108
(801) 213-3751
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22003878A
IN
Other
Enumeration date
09/16/2015
Last updated
09/16/2015
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