Provider Demographics
NPI:1609973247
Name:KEENE, KAREN S (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:S
Last Name:KEENE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 THOMPSON LN N
Mailing Address - Street 2:
Mailing Address - City:VINE GROVE
Mailing Address - State:KY
Mailing Address - Zip Code:40175-6385
Mailing Address - Country:US
Mailing Address - Phone:270-828-6380
Mailing Address - Fax:270-828-6380
Practice Address - Street 1:1190 THOMPSON LN N
Practice Address - Street 2:
Practice Address - City:VINE GROVE
Practice Address - State:KY
Practice Address - Zip Code:40175-6385
Practice Address - Country:US
Practice Address - Phone:270-828-6380
Practice Address - Fax:270-828-6380
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-2703235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist