Individual
KATHRYN M. KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
903 MINERAL POINT AVE, JANESVILLE, WI 53548-2970
(608) 756-5555
(608) 756-0174
Mailing address
903 MINERAL POINT AVE, JANESVILLE, WI 53548-2970
(608) 756-5555
(608) 756-0174
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
3906125
WI
103T00000X
Psychologist
Primary
2891-57
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1750541835
BCBSWI
WI
05
—
1750541835
—
WI
01
—
KELLEKA2
MERCYCARE INSURANCE
WI
Enumeration date
06/12/2008
Last updated
01/16/2017
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