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General NPI Number Information
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NPI Number | 1013555697
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Entity Type | Individual
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Provider Name | ABBY KEENER CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 12/14/2019
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Last Update Date | 12/14/2019
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Provider Practice Location Address
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Address Line | 117 N HIGHLAND AVE
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City | LOS ANGELES
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State | CA
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Zip | 90036-3030
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Country | US
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Telephone | 323-954-0887
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Fax |
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Provider Business Mailing Address
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Address Line | 700 S MYRTLE AVE APT 234
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City | MONROVIA
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State | CA
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Zip | 91016-8412
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Country | US
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Telephone | 810-287-4889
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 23192
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License Number State | CA
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