Provider Demographics
NPI:1891474466
Name:KEENAN, HOPE (MA CCC SLP)
Entity Type:Individual
Prefix:
First Name:HOPE
Middle Name:
Last Name:KEENAN
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:HOPE
Other - Middle Name:
Other - Last Name:WOODRUFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:784 S CLEARWATER LOOP STE R
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-9599
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:784 S CLEARWATER LOOP STE R
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-9599
Practice Address - Country:US
Practice Address - Phone:208-219-7695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID3695235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist