Provider Demographics
NPI:1265616379
Name:KEELER, ALLISON KATHLEEN (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:KATHLEEN
Last Name:KEELER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 PARK VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888-2507
Mailing Address - Country:US
Mailing Address - Phone:508-692-7190
Mailing Address - Fax:
Practice Address - Street 1:247 PARK VIEW AVE
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888-2507
Practice Address - Country:US
Practice Address - Phone:508-692-7190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-26
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7305235Z00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist