Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1003384181 |
---|---|
Provider Name | Dr. Patricia Keeler |
First Address | Cuba, NM 87013-0070 |
Second Address | Cuba, NM 87013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2018 |
Last Update Date | 07/11/2018 |