Individual
DR. ELLEN KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
81 LINCOLN AVE, DEER PARK, NY 11729-7015
(631) 902-0505
Mailing address
81 LINCOLN AVE, DEER PARK, NY 11729-7015
(631) 902-0505
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
013125
NY
Other
Enumeration date
09/11/2014
Last updated
09/11/2014
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