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General NPI Number Information
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NPI Number | 1144522913
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Entity Type | Individual
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Provider Name | KELLY ANN KEILMAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/29/2010
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Last Update Date | 11/29/2010
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Provider Practice Location Address
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Address Line | 410 CENTRAL AVE STE 502
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City | GREAT FALLS
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State | MT
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Zip | 59401-3128
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Country | US
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Telephone | 406-727-3152
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Fax |
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Provider Business Mailing Address
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Address Line | 1421 3RD AVE N
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City | GREAT FALLS
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State | MT
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Zip | 59401-1441
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Country | US
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Telephone | 406-727-3279
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 828
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License Number State | MT
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