Provider Demographics
NPI:1285465203
Name:KEATHLEY, MARGARET ELIZABETH
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ELIZABETH
Last Name:KEATHLEY
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 1:6049 TOMBLESON RD
Mailing Address - Street 2:
Mailing Address - City:LETART
Mailing Address - State:WV
Mailing Address - Zip Code:25253-9378
Mailing Address - Country:US
Mailing Address - Phone:304-519-4746
Mailing Address - Fax:
Practice Address - Street 1:6049 TOMBLESON RD
Practice Address - Street 2:
Practice Address - City:LETART
Practice Address - State:WV
Practice Address - Zip Code:25253-9378
Practice Address - Country:US
Practice Address - Phone:304-519-4746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency