Provider Demographics
NPI:1194073742
Name:SPEAR, KEELYN A (DS)
Entity type:Individual
Prefix:
First Name:KEELYN
Middle Name:A
Last Name:SPEAR
Suffix:
Gender:F
Credentials:DS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721-5327
Mailing Address - Country:US
Mailing Address - Phone:508-679-5233
Mailing Address - Fax:508-679-6211
Practice Address - Street 1:56 LEPES RD
Practice Address - Street 2:
Practice Address - City:TIVERTON
Practice Address - State:RI
Practice Address - Zip Code:02878-1302
Practice Address - Country:US
Practice Address - Phone:401-413-4586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator