Organization
FOX AND FERNS MENTAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL E. KEESLER JD, PHD (OWNER)
(215) 704-9832
Entity
Organization
Contact information
Practice address
77 ROCHELLE AVE, PHILADELPHIA, PA 19128-3809
(215) 704-9832
Mailing address
77 ROCHELLE AVE, PHILADELPHIA, PA 19128-3809
(215) 704-9832
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
11/08/2019
Last updated
11/08/2019
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