Keller, Lisa J

Keller, Lisa J is an individual health care provider with primary practice located at 3505 8Th St S Ste 3 , Moorhead MN 56560-5108. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Keller, Lisa J can be contacted via phone (701) 532-0991.

Contact Information

Primary practice address
3505 8Th St S Ste 3 Moorhead MN 56560-5108
Phone: (701) 532-0991
Fax: (701) 532-0428
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X LP6349 Minnesota

Profile Details

NPI number 1346676897
LBN Legal business name Keller, Lisa J
Credentials PSY.D., LP
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 16th, 2013
Last updated Feb 9th, 2024 - about 9 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346676897 NPPES
Minnesota Other H400917182 ENROLLMENT PART B

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