Doctor Name: | DR. KEITH ANDREW PUFFER |
NPI Number: | 1447460936 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D., LMHC, NCC |
License Number: | 39000452A |
Business Practice Address: | 301 E. Wabash Converse, IN - 46919 |
Business Phone Number: | 7656039574 |
Business Fax Number: | 7656772487 |
Mailing Address: | 5215 N Peconga Dr, MARION |
State: | IN |
Postal Code: | 469529672 |
Phone Number: | 7656039574 |
Fax Number: | 7656772487 |
NPI Enumeration Date: | 05/23/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 39000452A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |