Individual
ERIN C KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1441 CHARIC DR, WILDWOOD, MO 63021-2001
(888) 365-6271
Mailing address
5208 MARDEL AVE, SAINT LOUIS, MO 63109-1763
(314) 706-0296
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2016028924
MO
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2016028924
LICENSE
MO
Enumeration date
04/20/2009
Last updated
08/27/2019
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