Individual
RANDALL KEYS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6651 CHIPPEWA ST, SUITE 224, SAINT LOUIS, MO 63109-2538
(314) 645-6840
Mailing address
14616 KENDALL RIDGE DR, CHESTERFIELD, MO 63017-2161
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
11/20/2010
Last updated
11/20/2010
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