Mary Ann Keatley, PH.D., CCC, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

MARY ANN KEATLEY, PH.D., CCC, LLC

Practice address

321 N Whitcomb St
Fort Collins, CO 80521-2041

Phone

(970) 221-3456

NPI assigned

May 19, 2009

Last updated

Sep 10, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mary Ann Keatley, PH.D.

Title

Single Member LLC

Phone

(303) 447-0022

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252540800000",
    "number": "1861627861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 30TH ST",
            "address_2": "SUITE 120",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011022",
            "telephone_number": "303-447-0022",
            "fax_number": "970-221-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 N WHITCOMB ST",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805212041",
            "telephone_number": "970-221-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY ANN KEATLEY, PH.D., CCC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-19",
        "last_updated": "2009-09-10",
        "status": "A",
        "authorized_official_last_name": "KEATLEY",
        "authorized_official_first_name": "MARY ANN",
        "authorized_official_title_or_position": "SINGLE MEMBER LLC",
        "authorized_official_telephone_number": "303-447-0022",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Speech-Language Pathologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.