# PSYCHOTHERAPY - PSICOTERAPIA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639574999
- **Authorized official:** MRS. MARIA ANGELICA KELLER LICSW (PSYCHOTHERAPIST)
- **Authorized official phone:** (651) 214-5170

## Contact information

- **Practice address:** 900 AMERICAN BLVD E, 142, BLOOMINGTON, MN 55420-1392
- **Practice address phone:** (651) 214-5170
- **Mailing address:** 1981 CROWN POINT DR, MENDOTA HEIGHTS, MN 55118-4203
- **Mailing address phone:** (651) 214-5170

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | 16155 | MN | Yes |

## Other

- **Enumeration date:** 10/29/2014
- **Last updated:** 10/29/2014