Provider Information for 1720062631
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Ms. NOREEN KEILTY LICSW
Sex: Female
NPI: 1720062631
Last Updated: 2016-07-12
Certification Date:
Certification Date:
Details
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NPI | 1720062631 | ||||||||
Enumeration Date | 2005-12-05 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | NO | ||||||||
Status | Active | ||||||||
Mailing Address | 8170 33RD AVE S PO BOX 1309 MAIL STOP 21110Q MINNEAPOLIS, MN 55425-4516 United States Phone: | Fax: | ||||||||
Primary Practice Address | 3800 PARK NICOLLET BLVD ST LOUIS PARK, MN 55416-2527 United States Phone: 952-993-3307 | Fax: | ||||||||
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