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General NPI Number Information
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NPI Number | 1982445755
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Entity Type | Individual
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Provider Name | ASHLEY LYNN KELLER LMSW
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Gender | Female
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Dates
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Enumeration Date | 06/04/2024
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 2922 N SPRING MEADOW CT
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City | WICHITA
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State | KS
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Zip | 67205-1659
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Country | US
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Telephone | 316-250-5007
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Fax |
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Provider Business Mailing Address
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Address Line | 3200 FARMINGTON RD
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City | HUTCHINSON
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State | KS
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Zip | 67502-2474
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Country | US
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Telephone | 913-744-1926
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 13619
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License Number State | KS
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