Provider Demographics
NPI:1568787125
Name:KEILHOLZ, RICHARD J (M ED)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:J
Last Name:KEILHOLZ
Suffix:
Gender:M
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9507 MARIPOSA GRV
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4367
Mailing Address - Country:US
Mailing Address - Phone:210-467-9267
Mailing Address - Fax:
Practice Address - Street 1:9507 MARIPOSA GRV
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4367
Practice Address - Country:US
Practice Address - Phone:210-467-9267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61664101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health