Provider Demographics
NPI:1912186867
Name:KEELE, KRISTI LYNN (SLP)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:LYNN
Last Name:KEELE
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 1:245 SLEEPY HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15216-1713
Mailing Address - Country:US
Mailing Address - Phone:724-331-3039
Mailing Address - Fax:
Practice Address - Street 1:2893 BANKSVILLE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15216-2815
Practice Address - Country:US
Practice Address - Phone:412-572-6761
Practice Address - Fax:412-572-6762
Is Sole Proprietor?:No
Enumeration Date:2007-10-29
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL008999235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
204151437OtherASPIRE TAX ID