Individual
AMY LYNN KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
476 PORTLAND WAY N, GALION, OH 44833-1115
(419) 468-3676
Mailing address
476 PORTLAND WAY N, GALION, OH 44833-1115
(419) 468-3676
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP.06453
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1965
—
OH
Enumeration date
10/31/2019
Last updated
10/31/2019
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