Provider Demographics
NPI:1740454743
Name:KEYES, REBECCA MAY
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:MAY
Last Name:KEYES
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 1:112 E HARFORD ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18337-1002
Mailing Address - Country:US
Mailing Address - Phone:570-296-5156
Mailing Address - Fax:570-296-2592
Practice Address - Street 1:112 E HARFORD ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:PA
Practice Address - Zip Code:18337-1002
Practice Address - Country:US
Practice Address - Phone:570-296-5156
Practice Address - Fax:570-296-2592
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009175235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist