Individual
HEIDI MARIE KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1520 GERMANTOWN ST, DAYTON, OH 45417-3318
(937) 269-5816
Mailing address
5331 LOGAN AVE, DAYTON, OH 45431-2760
(937) 269-5816
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
441859
OH
Other
Enumeration date
05/10/2018
Last updated
05/10/2018
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