Individual
DOROTHY JEAN KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
3470 BLAZER PKWY, LEXINGTON, KY 40509-1200
(859) 323-6021
Mailing address
2333 ALUMNI PARK PLZ, SUITE 200, LEXINGTON, KY 40517-4012
(859) 257-7910
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0878
KY
101YM0800X
Mental Health Counselor
0878
KY
101YP2500X
Professional Counselor
0878
KY
106H00000X
Marriage & Family Therapist
0878
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
82000068
—
KY
Enumeration date
10/24/2006
Last updated
04/14/2008
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