Dr. Dominik L Keller, PHD
Psychologist, School in Southaven, Mississippi
1710627922- Practice location
- 5915 Getwell RD Bldg B, Southaven, MS 38672-6455
- Phone
- 662-349-2979
- Fax
- —
- Last updated
- December 15, 2022
Dominik Lia Keller is a Psychologist, School based in Southaven, MS. Dominik Lia Keller practices in Southaven, MS and has the professional credentials of PHD. The NPI Number for Dominik Lia Keller is 1710627922 and holds a License No. 621149 (MS). The current practice location address for Dominik Lia Keller is 5915 Getwell RD Bldg B, Southaven, MS 38672-6455 and can be reached out via phone at 662-349-2979.
Provider Profile Details
- NPI Number
- 1710627922
- Provider Name
- Dominik Lia Keller
- Credential
- PHD
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 5915 Getwell RD Bldg B, Southaven, MS 38672-6455
- Phone Number
- 662-349-2979
- Primary Taxonomy
- Psychologist, School · 103TS0200X
- Sole Proprietor
- No
- Provider Enumeration Date
- March 29, 2022
- Last Update Date
- December 15, 2022
- Certification Date
- December 15, 2022
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 5915 Getwell RD Bldg B
Southaven, MS 38672-6455 - City
- Southaven
- State
- Mississippi
- Zip
- 38672-6455
- Phone Number
- 662-349-2979
Provider Business Mailing Address Details
- Address
- 5915 Getwell RD Bldg B
Southaven, MS 38672-6455 - City
- Southaven
- State
- MS
- Zip
- 38672-6455
- Phone Number
- 662-349-2979
License Information
- License Number (1)
- 621149
- License State (1)
- MS
- Taxonomy (1)
- Psychologist, School · 103TS0200X · Primary
- Taxonomy (2)
- Behavior Technician · 106S00000X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Dr. Dominik L Keller, PHD?
The NPI number of Dr. Dominik L Keller, PHD is 1710627922. It was assigned on March 29, 2022 and is currently active in the NPPES registry.
What is the specialty of Dr. Dominik L Keller, PHD?
Dr. Dominik L Keller, PHD is registered under the primary taxonomy Psychologist, School (code 103TS0200X), licensed in MS under license number 621149.
Where does Dr. Dominik L Keller, PHD practice?
The practice location is 5915 Getwell RD Bldg B, Southaven, MS 38672-6455. The office can be reached at 662-349-2979 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1710627922 directly on the NPPES registry website.