Individual
SUSAN GAIL KEEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CBHT
Contact information
Practice address
2789 ORTIZ AVE, FORT MYERS, FL 33905-7806
(239) 275-3222
Mailing address
2789 ORTIZ AVE, FORT MYERS, FL 33905-7806
(239) 275-3222
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CBHT 1037
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K400796478280
DL
FL
Enumeration date
07/12/2012
Last updated
07/12/2012
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