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Individual

MRS. ANDREA D KEYS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LADC

Contact information

Practice address
6000 BASS LAKE ROAD, SUITE #201, CRYSTAL, MN 55429
(612) 578-7901
(612) 600-6956
Mailing address
6000 BASS LAKE ROAD, SUITE #201, CRYSTAL, MN 55429-2794
(612) 578-7901
(612) 600-6956

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
302219
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
302219
LICENSE NUMBER
MN
Enumeration date
07/17/2009
Last updated
05/30/2019
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