Provider Demographics
NPI:1336361203
Name:KEEL, BOBBY WAYNE (LPC)
Entity type:Individual
Prefix:MR
First Name:BOBBY
Middle Name:WAYNE
Last Name:KEEL
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 HYANNIS PORT SOUTH
Mailing Address - Street 2:
Mailing Address - City:CROSBY
Mailing Address - State:TX
Mailing Address - Zip Code:77532
Mailing Address - Country:US
Mailing Address - Phone:281-462-0707
Mailing Address - Fax:281-462-0707
Practice Address - Street 1:23538 COONS RD.
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-1120
Practice Address - Country:US
Practice Address - Phone:281-374-0777
Practice Address - Fax:281-251-8406
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11633101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional