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General NPI Number Information
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NPI Number | 1730646191
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Entity Type | Individual
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Provider Name | KELEY ANNE SMITH-KELLER LPC
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Gender | Female
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Dates
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Enumeration Date | 02/21/2019
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Last Update Date | 02/21/2019
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Provider Practice Location Address
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Address Line | 1105 W 8TH ST
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City | YANKTON
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State | SD
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Zip | 57078-3725
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Country | US
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Telephone | 605-668-1363
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Fax |
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Provider Business Mailing Address
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Address Line | 1901 CEDAR ST
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City | YANKTON
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State | SD
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Zip | 57078-2120
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Country | US
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Telephone | 605-670-0407
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC882
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License Number State | SD
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