Individual
MS. ILISA J. KEITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LAC
Contact information
Practice address
1425 W ELLIOT RD STE 201, GILBERT, AZ 85233-5142
(602) 399-7871
Mailing address
1425 W ELLIOT RD STE 201, GILBERT, AZ 85233-5142
(602) 399-7871
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
10/05/2016
Last updated
03/27/2017
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