Organization
ENTWINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHASITY MARIE KELLER LCSW (CLINICAL SOCIAL WORKER)
(701) 532-0991
Entity
Organization
Contact information
Practice address
4342 15TH AVE S STE 103, FARGO, ND 58103-1125
(701) 532-0991
(701) 532-0428
Mailing address
4342 15TH AVE S STE 103, FARGO, ND 58103-1125
(701) 532-0991
(701) 532-0428
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
04/08/2021
Last updated
11/13/2023
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