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Individual

DR. WILLIAM PRESLEY KEETON III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
22593 THREE NOTCH RD, CALIFORNIA, MD 20619-3054
(301) 862-2505
(301) 862-2548
Mailing address
22593 THREE NOTCH RD, CALIFORNIA, MD 20619-3054
(301) 862-2505
(301) 862-2548

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
05643
MD
103TC0700X
Clinical Psychologist
1406
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0426M
BLUE CROSS/BLUE SHIELD
NC
05
6000345
NC
Enumeration date
10/26/2006
Last updated
12/08/2015
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