JIMMY L KELLER

SLIDELL, LA
NPI1386910016
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: LA  2959)
Enumeration Date2012-03-27
Last Update Date2012-03-27
Business Address
-- JIMMY L KELLER CIT
2238 1ST ST
SLIDELL, LA 70458-3606
Phone number: 985-690-6622
Mailing Address
-- JIMMY L KELLER CIT
2238 1ST ST
SLIDELL, LA 70458-3606
Phone number: 985-690-6622
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