Provider Demographics
NPI:1194472142
Name:KEEN, AMARI MARIE
Entity Type:Individual
Prefix:
First Name:AMARI
Middle Name:MARIE
Last Name:KEEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 BEECHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-2343
Mailing Address - Country:US
Mailing Address - Phone:330-258-3388
Mailing Address - Fax:
Practice Address - Street 1:449 BEECHWOOD DR
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-2343
Practice Address - Country:US
Practice Address - Phone:330-258-3388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver