Individual
LISA KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSC, LPC, CSAT
Contact information
Practice address
9500 N ORACLE RD, SUITE 162J, TUCSON, AZ 85704-8523
(520) 349-6016
Mailing address
PO BOX 22409, TUCSON, AZ 85734-2409
(520) 349-6016
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-14464
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPC-14464
LICENSED PROFESSIONAL COUNSELOR
AZ
Enumeration date
07/30/2013
Last updated
06/07/2014
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