Provider Demographics
NPI:1275281982
Name:KELLER, DARLENE ANN (SLP)
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:ANN
Last Name:KELLER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:DARLENE
Other - Middle Name:ANN
Other - Last Name:BROWNING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:2206 DELAWARE
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-2069
Mailing Address - Country:US
Mailing Address - Phone:619-322-9235
Mailing Address - Fax:
Practice Address - Street 1:902 N 10TH ST
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541-4829
Practice Address - Country:US
Practice Address - Phone:254-336-0366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118628235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist