Individual
SALLY KECKEISEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6600 EXCELSIOR BLVD, SAINT LOUIS PARK, MN 55426-4744
(952) 993-7700
Mailing address
8170 33RD AVE S, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP7268
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/21/2023
Last updated
10/03/2025
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