Organization
PARADISE COUNSELING & CONSULTATION CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTIN E KELLER EDD (PSYCHOLOGIST)
(602) 996-8619
Entity
Organization
Contact information
Practice address
11020 N TATUM BLVD, PHOENIX, AZ 85028-6072
(602) 996-8619
(602) 996-7932
Mailing address
11020 N TATUM BLVD, PHOENIX, AZ 85028-6072
(602) 996-8619
(602) 996-7932
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
503
AZ
Other
Enumeration date
05/23/2008
Last updated
05/23/2008
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