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Individual
MAXINE LYNN KELLER
Active
Individual
MAXINE LYNN KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCADC, CADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
166100
KY
101YA0400X
Addiction (Substance Use Disorder) Counselor
ADCADC00220812
KY
Other
Enumeration date
01/06/2016
Last updated
08/04/2017
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