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General NPI Number Information
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NPI Number | 1629361142
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Entity Type | Individual
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Provider Name | LAURA ANN KEEHNER CCC-SLP, BCBA
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Gender | Female
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Dates
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Enumeration Date | 05/17/2011
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Last Update Date | 06/24/2014
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Provider Practice Location Address
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Address Line | 1011 DAVIS ST
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City | DUBUQUE
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State | IA
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Zip | 52001-1397
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Country | US
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Telephone | 563-556-7878
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Fax | 563-557-3822
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Provider Business Mailing Address
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Address Line | 1011 DAVIS ST
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City | DUBUQUE
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State | IA
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Zip | 52001-1397
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Country | US
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Telephone | 563-556-7878
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Fax | 563-557-3822
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-12-12137
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 01558
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License Number State | IA
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