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General NPI Number Information
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NPI Number | 1225620909
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Entity Type | Individual
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Provider Name | MOLLY O'KEEFE
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Gender | Female
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Dates
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Enumeration Date | 02/04/2021
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 3138 KIMBALL AVE
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City | WATERLOO
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State | IA
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Zip | 50702-5253
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Country | US
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Telephone | 319-234-4360
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Fax |
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Provider Business Mailing Address
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Address Line | 2401 4TH ST SW STE B
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City | WAVERLY
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State | IA
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Zip | 50677-4329
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Country | US
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Telephone | 319-774-5366
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 120526
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License Number State | IA
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