Provider Demographics
NPI:1699082529
Name:KEYS, MARGARET (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:KEYS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1335 FILBERT ST
Mailing Address - Street 2:APT. 102
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-1772
Mailing Address - Country:US
Mailing Address - Phone:617-872-5152
Mailing Address - Fax:
Practice Address - Street 1:2340 IRVING ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-1641
Practice Address - Country:US
Practice Address - Phone:414-339-4202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-14
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18904235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA18904OtherSPEECH-LANGUAGE PATHOLOGIST LICENSE
12079889OtherAMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION