Provider Demographics
NPI:1225620909
Name:O'KEEFE, MOLLY
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:O'KEEFE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 4TH ST SW STE B
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:IA
Mailing Address - Zip Code:50677-4329
Mailing Address - Country:US
Mailing Address - Phone:319-774-5366
Mailing Address - Fax:
Practice Address - Street 1:3138 KIMBALL AVE
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-5253
Practice Address - Country:US
Practice Address - Phone:319-234-4360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-04
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X, 237700000X
IA120526237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician