Provider Demographics
NPI:1508299140
Name:O'KEEFFE, KATHERINE MARY (SLP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MARY
Last Name:O'KEEFFE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 ARROWHEAD CT
Mailing Address - Street 2:
Mailing Address - City:ELM GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53122-1305
Mailing Address - Country:US
Mailing Address - Phone:262-785-2727
Mailing Address - Fax:
Practice Address - Street 1:1900 ARROWHEAD CT
Practice Address - Street 2:
Practice Address - City:ELM GROVE
Practice Address - State:WI
Practice Address - Zip Code:53122-1305
Practice Address - Country:US
Practice Address - Phone:262-785-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-19
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI409-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist