Provider Information for 1932196987
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THOMAS B KELLER LMHC
Sex: Male
NPI: 1932196987
Last Updated: 2008-05-05
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1932196987 | ||||||||
| Enumeration Date | 2005-10-04 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2500 E HALLANDALE BEACH BLVD 511-C HALLANDALE BEACH, FL 33009-4834 United States Phone: 954-567-8446 | Fax:954-457-5661 | ||||||||
| Primary Practice Address | 2500 E HALLANDALE BEACH BLVD 511-C HALLANDALE BEACH, FL 33009-4834 United States Phone: 954-567-8446 | Fax:954-457-5661 | ||||||||
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