Provider Demographics
NPI:1841403870
Name:KEATING, AMY (SLP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:KEATING
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 1:311 S ASHBY
Mailing Address - Street 2:
Mailing Address - City:CHANUTE
Mailing Address - State:KS
Mailing Address - Zip Code:66720
Mailing Address - Country:US
Mailing Address - Phone:620-431-2441
Mailing Address - Fax:
Practice Address - Street 1:BOX 366 1001 WEST MAIN ST
Practice Address - Street 2:
Practice Address - City:CHERRYVALE
Practice Address - State:KS
Practice Address - Zip Code:67335
Practice Address - Country:US
Practice Address - Phone:620-336-2102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2288235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist