Individual
ALICE KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
20 N BROADWAY, NYACK, NY 10960-2636
(845) 353-3435
Mailing address
20 N BROADWAY, NYACK, NY 10960-2636
(845) 353-3435
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
071254-1
NY
Other
Enumeration date
01/07/2011
Last updated
01/07/2011
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