Individual
JACQUELINE KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
810 COTTAGEVIEW DR STE 101, TRAVERSE CITY, MI 49684-2392
(231) 943-1553
Mailing address
348 KNOLLWOOD DR, TRAVERSE CITY, MI 49686-1859
(248) 840-5436
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401007863
MI
Other
Enumeration date
10/11/2018
Last updated
01/17/2021
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