Individual
KEEGAN KAVANAGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2460 INDIA HOOK RD STE AND105, ROCK HILL, SC 29732-3530
(803) 366-6250
Mailing address
181 W PROFESSIONAL PARK CT STE 1, BOWLING GREEN, KY 42104-3250
(270) 777-9283
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
17-40781
SC
Other
Enumeration date
12/08/2017
Last updated
12/08/2017
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