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Individual

ANGELA LYNN KEITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD, LPC

Contact information

Practice address
1016 W UNIVERSITY AVE, SUITE 202, FLAGSTAFF, AZ 86001
(928) 773-7774
(928) 774-1148
Mailing address
1016 W UNIVERSITY AVE, SUITE 202, FLAGSTAFF, AZ 86001
(928) 773-7774
(928) 774-1148

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
11038
AZ
101YP2500X
Professional Counselor
LPC-11038
AZ
103TC1900X
Counseling Psychologist
Primary
4035
AZ

Other

Enumeration date
08/14/2006
Last updated
02/10/2012
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