Provider Demographics
NPI:1922393222
Name:KEENA, KATHERINE PAIGE
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:PAIGE
Last Name:KEENA
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 1:1701 LIBRARY BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-1567
Mailing Address - Country:US
Mailing Address - Phone:317-881-9923
Mailing Address - Fax:
Practice Address - Street 1:1230 TIMBROOK LN
Practice Address - Street 2:
Practice Address - City:BEECH GROVE
Practice Address - State:IN
Practice Address - Zip Code:46107-3330
Practice Address - Country:US
Practice Address - Phone:260-615-1703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist