Individual
WADE KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LAMFT
Contact information
Practice address
15852 PENNSYLVANIA AVE, PRIOR LAKE, MN 55372-2270
(612) 991-2937
Mailing address
15852 PENNSYLVANIA AVE, PRIOR LAKE, MN 55372-2270
(612) 991-2937
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
4431
MN
Other
Enumeration date
09/26/2023
Last updated
09/26/2023
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