Individual
CLARISSA KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1050 WILLSHIRE DR STE 175, DETROIT, MI 48277-0001
(800) 693-1916
Mailing address
4512 INTERNATIONAL CT # D69, BERRIEN SPRINGS, MI 49103-1751
(269) 362-4635
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6352000864
MI
Other
Enumeration date
08/30/2024
Last updated
08/30/2024
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