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General NPI Number Information
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NPI Number | 1780078386
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Entity Type | Organization
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Legal Business Name | KELLER PSYCHOLOGICAL SERVICES, P.C.
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Dates
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Enumeration Date | 03/23/2015
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Last Update Date | 11/25/2018
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Provider Practice Location Address
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Address Line | 4955 N BAILEY AVE STE 214
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City | AMHERST
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State | NY
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Zip | 14226-1206
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Country | US
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Telephone | 716-650-0287
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Fax | 716-970-4470
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Provider Business Mailing Address
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Address Line | 4955 N BAILEY AVE STE 214
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City | AMHERST
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State | NY
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Zip | 14226-1206
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Country | US
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Telephone | 716-650-0287
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Fax | 716-970-4470
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | DR. CHRISTOPHER JOSEPH KELLER
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Credential | PSYD
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Telephone | 716-450-3934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 019744
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License Number State | NY
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