Individual
MRS. GINA MICHELE KEISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LSW
Contact information
Practice address
1003 N CUMMINGS LN, WASHINGTON, IL 61571-9646
(309) 444-1000
Mailing address
343 OAKWOOD AVE, EAST PEORIA, IL 61611-3644
(309) 357-9763
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.110421
IL
Other
Enumeration date
04/11/2023
Last updated
04/11/2023
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