Individual
MRS. MARISSA DANIELLE KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
45 ROUTE 11, SHAMOKIN DAM, PA 17876-9116
(570) 931-3849
Mailing address
9 BANKS AVE, MCADOO, PA 18237-2508
(888) 726-4774
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH003476
PA
Other
Enumeration date
07/07/2022
Last updated
07/07/2022
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