Individual
MICHELE KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
405 E EXCELSIOR AVE, VINITA, OK 74301-4226
(918) 256-6476
(918) 256-3628
Mailing address
405 E EXCELSIOR AVE, VINITA, OK 74301-4226
(918) 256-6476
(918) 256-3628
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2011035731
MO
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
2011035731
MO
Other
Enumeration date
03/10/2014
Last updated
07/08/2020
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