Individual
KEITH WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CLINICAL SOCIAL WORK
Contact information
Practice address
100 EMANCIPATION DR, HAMPTON, VA 23667-0001
(757) 722-6691
(757) 728-3183
Mailing address
100 EMANCIPATION DR, HAMPTON, VA 23667-0001
(757) 722-6691
(757) 728-3183
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW005181
GA
Other
Enumeration date
04/20/2015
Last updated
04/20/2015
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