Individual provider · Type 1 NPI

Keith Leslie Deraad, CPRP

Mental Health Counselor · Minneapolis, MN

NPI number 1063532216 Active

Practice location

1825 Chicago Ave
Minneapolis, MN 55404-1939

Call (612) 752-8246 Map

Fax (612) 752-8203

Mailing address

3700 W 83rd St
Bloomington, MN 55431-1063

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1063532216

Keith Leslie Deraad, CPRP's National Provider Identifier is 1063532216, issued on Mar 30, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Minneapolis, MN. The record was last updated on Jul 8, 2007.