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NPI Code Detail

MEDICARE: TANAYA KELLER

MEDICARE: TANAYA KELLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1124971551
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANAYA KELLER
Provider Business Mailing Address
First Line : 10423 RED OAK DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70815-1661
Country : US
Telephone Number : 225-978-4993
Fax Number :
Provider Business Practice Location Address
First Line : 10423 RED OAK DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70815-1661
Country : US
Telephone Number : 225-978-4993
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2026
Last Update Date : 02/16/2026

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Directions to “ TANAYA KELLER ” Practice Location

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