Provider Demographics
NPI:1467041392
Name:FARNE, KEATON
Entity Type:Individual
Prefix:
First Name:KEATON
Middle Name:
Last Name:FARNE
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 1:4500 N STATE ROAD 7 STE 214
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33319-5877
Mailing Address - Country:US
Mailing Address - Phone:954-533-2226
Mailing Address - Fax:
Practice Address - Street 1:4500 N STATE ROAD 7 STE 214
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33319-5877
Practice Address - Country:US
Practice Address - Phone:954-533-2226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL45932355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant