Individual
KATHERINE ELIZABETH KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2 BLACK GUM TREE LN, KINGS PARK, NY 11754-1747
(631) 404-9077
Mailing address
2 BLACK GUM TREE LN, KINGS PARK, NY 11754-1747
(631) 404-9077
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
08/05/2013
Last updated
08/05/2013
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