Organization
JASON KELLER, PSY.D., PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON KELLER PSY.D. (DIRECTOR)
(502) 322-4884
Entity
Organization
Contact information
Practice address
1512 CRUMS LN, SUITE 305, LOUISVILLE, KY 40216-3861
(502) 322-4884
Mailing address
1512 CRUMS LN, SUITE 305, LOUISVILLE, KY 40216-3861
(502) 322-4884
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
103K00000X
Behavior Analyst
—
—
103TC0700X
Clinical Psychologist
Primary
1548
KY
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
Other
Enumeration date
10/06/2010
Last updated
10/06/2010
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