Individual
RUTH J KEILI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3562 OLD VILLAGE DR, ORANGE PARK, FL 32065-5521
(757) 812-3776
Mailing address
3562 OLD VILLAGE DR, ORANGE PARK, FL 32065-5521
(757) 812-3776
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
Other
Enumeration date
07/23/2020
Last updated
07/23/2020
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