| Doctor Name: | MRS. MICHELE COLLEEN KELLER |
| NPI Number: | 1033367925 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LAC, MA |
| License Number: | 1251 |
| Business Practice Address: | 1325 Wyoming St Missoula, MT - 598011725 |
| Business Phone Number: | 4065329800 |
| Business Fax Number: | 4065413032 |
| Mailing Address: | T-9 Fort Missoula, MISSOULA |
| State: | MT |
| Postal Code: | 598047202 |
| Phone Number: | 4065328400 |
| Fax Number: | 4065439316 |
| NPI Enumeration Date: | 09/04/2008 |
| NPI Last Update Date: | 09/04/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 1251 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |