Provider Demographics
NPI:1588024566
Name:KEEFER, PATRICIA MARGUERITE
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:MARGUERITE
Last Name:KEEFER
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 1:4606 PLEASANT CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43056-9019
Mailing Address - Country:US
Mailing Address - Phone:740-763-0728
Mailing Address - Fax:
Practice Address - Street 1:205 WEST RAMBO ST.
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:OH
Practice Address - Zip Code:43014
Practice Address - Country:US
Practice Address - Phone:740-599-6116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-03
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP12254235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist