Doctor Name: | REBECCA WOLFE KELLER |
NPI Number: | 1437174067 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 0904003037 |
Business Practice Address: | 576 Jefferson Ave Fort Eustis, VA - 236041373 |
Business Phone Number: | 7573147500 |
Business Fax Number: | 7573147854 |
Mailing Address: | 576 Jefferson Ave, FORT EUSTIS |
State: | VA |
Postal Code: | 236041373 |
Phone Number: | 7573147500 |
Fax Number: | 7573147854 |
NPI Enumeration Date: | 07/13/2006 |
NPI Last Update Date: | 02/27/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 0904003037 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |