Provider Demographics
NPI:1427681865
Name:KEELEN, MICHELLE GUADALUPE
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:GUADALUPE
Last Name:KEELEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1382 WESTLAWN DR
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70460-2568
Mailing Address - Country:US
Mailing Address - Phone:504-319-7032
Mailing Address - Fax:
Practice Address - Street 1:1382 WESTLAWN DR
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70460-2568
Practice Address - Country:US
Practice Address - Phone:504-319-7032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-13
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health