Individual
KEELAN VICTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
210 S BLACK HORSE PIKE, BLACKWOOD, NJ 08012-2955
(856) 542-8929
Mailing address
590 LOWER LANDING RD APT 13B, BLACKWOOD, NJ 08012-4215
(856) 542-8929
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
03/14/2018
Last updated
07/30/2020
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