Individual
MS. SUSAN CLARK KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
307 1ST AVE EAST, STE 3, KALISPELL, MT 59901-4965
(406) 257-3877
(406) 257-3907
Mailing address
307 1ST AVE EAST, STE 3, KALISPELL, MT 59901-4965
(406) 257-3877
(406) 257-3907
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
582LCSW
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0502537
—
MT
Enumeration date
05/20/2006
Last updated
07/08/2007
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