Individual
JACQUELYNNE MARIE KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 S RYAN DR APT 7203, RED OAK, TX 75154-4270
(469) 337-5097
Mailing address
200 S RYAN DR APT 7203, RED OAK, TX 75154-4270
(469) 337-5097
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
—
—
174N00000X
Lactation Consultant (Non-RN)
—
—
374J00000X
Doula
Primary
—
—
Other
Enumeration date
04/12/2018
Last updated
04/12/2018
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