Clarissa Keller, MS
Psychologist in Detroit, MI. Individual provider (NPI-1).
NPI number1265266274
StatusActive
Last updated in NPPESAug 30, 2024
Details
- NPI
- 1265266274
- Entity type
- Individual (NPI-1)
- Name
- Clarissa Keller
- Credential
- MS
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 30, 2024
- Certification date
- Aug 30, 2024
- Last updated
- Aug 30, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103T00000X | Psychologist | 6352000864 | MI | Yes |
Practice location
1050 Willshire Dr Ste 175Detroit, MI 48277-0001
Phone 800-693-1916
Mailing address
4512 International Ct # D69Berrien Springs, MI 49103-1751
Phone 269-362-4635
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