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General NPI Number Information
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NPI Number | 1639239445
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Entity Type | Organization
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Legal Business Name | KEY CORPORATION
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 03/13/2021
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Provider Practice Location Address
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Address Line | 1394 JACKSON ST STE 201
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City | SAINT PAUL
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State | MN
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Zip | 55117-4630
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Country | US
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Telephone | 651-603-8774
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Fax | 651-603-9009
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Provider Business Mailing Address
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Address Line | 1394 JACKSON ST STE 201
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City | SAINT PAUL
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State | MN
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Zip | 55117-4630
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Country | US
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Telephone | 651-603-8774
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Fax | 651-603-9009
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. THERESA M BOWLIN
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Credential |
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Telephone | 651-784-7828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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