Provider Demographics
NPI:1306154364
Name:KEIL, CHRISTOPHER D (SSW)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:D
Last Name:KEIL
Suffix:
Gender:M
Credentials:SSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 867
Mailing Address - Street 2:105 WEST 100 NORTH
Mailing Address - City:PRICE
Mailing Address - State:UT
Mailing Address - Zip Code:84501
Mailing Address - Country:US
Mailing Address - Phone:435-637-7200
Mailing Address - Fax:435-637-2377
Practice Address - Street 1:77 SOUTH 600 EAST
Practice Address - Street 2:
Practice Address - City:PRICE
Practice Address - State:UT
Practice Address - Zip Code:84501-3102
Practice Address - Country:US
Practice Address - Phone:435-637-4247
Practice Address - Fax:435-637-6465
Is Sole Proprietor?:No
Enumeration Date:2010-09-23
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10135521-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health