Provider Demographics
NPI:1912609488
Name:JERI JEAN KEENAN-CATTNACH
Entity Type:Organization
Organization Name:JERI JEAN KEENAN-CATTNACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JERI
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:KEENAN-CATTNACH
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:605-366-8150
Mailing Address - Street 1:5104 E 64TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-3058
Mailing Address - Country:US
Mailing Address - Phone:605-366-8150
Mailing Address - Fax:
Practice Address - Street 1:5104 E 64TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-3058
Practice Address - Country:US
Practice Address - Phone:605-366-8150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency