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Individual
LISA M KECK
Active
Individual
LISA M KECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.180655
OH
175T00000X
Peer Specialist
0002772
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000
LICENSURE BOARD
OH
Enumeration date
07/29/2022
Last updated
01/23/2023
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