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General NPI Number Information
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NPI Number | 1679371900
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Entity Type | Individual
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Provider Name | KEETON ANN ROGERS RBT
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Gender | Female
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Dates
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Enumeration Date | 03/04/2025
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 2211 S PARK AVE STE 4&5&7
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City | ALEXANDRIA
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State | IN
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Zip | 46001-8084
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Country | US
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Telephone | 765-705-4138
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Fax |
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Provider Business Mailing Address
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Address Line | 207 SIGLER STREET
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City | FRANKTON
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State | IN
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Zip | 46044
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Country | US
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Telephone |
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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 | RBT-24-349926
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License Number State | IN
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