| Doctor Name: | ANISSA NICOLE KEYES |
| NPI Number: | 1154686590 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LMFT, LICSW |
| License Number: | 23288 |
| Business Practice Address: | 3300 County Road 10 Ste 204b Brooklyn Center, MN - 554293072 |
| Business Phone Number: | 7634475573 |
| Business Fax Number: | 7632738892 |
| Mailing Address: | 3300 County Road 10, Ste 204b BROOKLYN CENTER |
| State: | MN |
| Postal Code: | 554293072 |
| Phone Number: | 7634475573 |
| Fax Number: | 7632738892 |
| NPI Enumeration Date: | 07/11/2012 |
| NPI Last Update Date: | 01/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 23288 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |