Individual
MRS. JESSICA A KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1045 JAMES ST, SYRACUSE, NY 13203-2730
(315) 425-1004
Mailing address
4846 BURLESON RD, ONEIDA, NY 13421-3206
(315) 363-4684
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
688907
NY
Other
Enumeration date
01/22/2014
Last updated
01/24/2014
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