Provider Demographics
NPI:1891325387
Name:KEELING, BRIANA KATHARINE
Entity type:Individual
Prefix:
First Name:BRIANA
Middle Name:KATHARINE
Last Name:KEELING
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 1:903 OSO NEGRO
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-1843
Mailing Address - Country:US
Mailing Address - Phone:210-882-6340
Mailing Address - Fax:
Practice Address - Street 1:8221 PALISADES DR
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3402
Practice Address - Country:US
Practice Address - Phone:210-600-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112045235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist