Individual
CARLY GRACE KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22001 FAIRMOUNT BLVD, SHAKER HEIGHTS, OH 44118-4897
(216) 932-2800
Mailing address
22001 FAIRMOUNT BLVD, SHAKER HEIGHTS, OH 44118-4897
(216) 932-2800
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S1903323
OH
Other
Enumeration date
02/16/2019
Last updated
02/16/2019
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