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General NPI Number Information
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NPI Number | 1457669277
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Entity Type | Organization
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Legal Business Name | MAUREEN MCKEOWN, SPEECH PATHOLOGIST, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 09/14/2010
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Last Update Date | 01/15/2020
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Provider Practice Location Address
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Address Line | 3150 18TH ST SUITE 264 BOX 302
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City | SAN FRANCISCO
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State | CA
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Zip | 94110-2074
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Country | US
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Telephone | 415-672-3653
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Fax |
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Provider Business Mailing Address
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Address Line | 3150 18TH ST SUITE 264 BOX 302
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City | SAN FRANCISCO
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State | CA
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Zip | 94110-2074
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Country | US
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Telephone | 415-672-3653
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MAUREEN THERESA MCKEOWN
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Credential | CCC-SLP
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Telephone | 415-672-3653
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | SP 5268
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License Number State | CA
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