Individual
JACLYN KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1516 E SPRING RIDGE CIR, WINTER GARDEN, FL 34787-2164
(516) 574-9666
Mailing address
1516 E SPRING RIDGE CIR, WINTER GARDEN, FL 34787-2164
(516) 574-9666
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
05/09/2016
Last updated
02/26/2021
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