Individual
EDEN KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
4509 20TH AVE, PETERSON, IA 51047-7524
(712) 295-7601
Mailing address
728 LILY CT, STORM LAKE, IA 50588-4603
(712) 229-2721
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
117387
IA
Other
Enumeration date
06/11/2024
Last updated
06/11/2024
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