Provider Demographics
NPI:1659784437
Name:O'KEEFE, MAUREEN SARA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:SARA
Last Name:O'KEEFE
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 1:3720 RUNESTAD CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-1573
Mailing Address - Country:US
Mailing Address - Phone:907-242-0220
Mailing Address - Fax:
Practice Address - Street 1:3720 RUNESTAD CIR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99502-1573
Practice Address - Country:US
Practice Address - Phone:907-242-0220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK486235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist