| NPI | 1821420779 |
|---|---|
| Former Name | KELLI ELIZABETH KECK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.017826) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MO 2013025362) |
| Enumeration Date | 2013-08-02 |
| Last Update Date | 2015-10-21 |