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General NPI Number Information
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NPI Number | 1609564582
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Entity Type | Individual
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Provider Name | KAITLYN HACKER-KEELING CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 04/27/2023
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Last Update Date | 08/30/2024
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Provider Practice Location Address
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Address Line | 5850 TOWN AND COUNTRY BLVD STE 201
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City | FRISCO
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State | TX
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Zip | 75034-6944
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Country | US
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Telephone | 817-345-7530
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Fax |
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Provider Business Mailing Address
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Address Line | 140 S RANGER ST
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City | HEREFORD
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State | TX
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Zip | 79045
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Country | US
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Telephone | 806-344-5248
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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 | 119597
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License Number State | TX
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