| Tristan Glenn Keller, LISW | |
|
2025 E Aztec Ave, Gallup, NM 87301-4803 | |
| (505) 863-3828 | |
| (505) 863-6612 |
| Full Name | Tristan Glenn Keller |
|---|---|
| Gender | Male |
| Speciality | Social Worker - Clinical |
| Location | 2025 E Aztec Ave, Gallup, New Mexico |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053346171 | NPI | - | NPPES |
| 50526 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | I-05565 (New Mexico) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Tristan Glenn Keller, LISW 219 Boulder Rd, Gallup, NM 87301-5795 Ph: (505) 863-3604 | Tristan Glenn Keller, LISW 2025 E Aztec Ave, Gallup, NM 87301-4803 Ph: (505) 863-3828 |
Summer B Hogue, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 516 E Nizhoni Blvd, Gallup, NM 87301 Phone: 505-722-1000 | |
Betty Sharon Spencer, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 516 E Nizhoni Blvd, Gallup, NM 87301 Phone: 505-722-1000 Fax: 928-697-4189 | |
Judy Martinez, Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 516 E Nizhoni Blvd, Gallup, NM 87301 Phone: 505-722-1000 | |
Sierra Rose Yazzie Asamoa-tutu, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 2025 E Aztec Ave, Gallup, NM 87301 Phone: 505-863-3120 | |
Beverly Tamanini, LISW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 208 1/2 E Hill Ave, Gallup, NM 87301 Phone: 505-863-1930 | |
Mr. Vernon Thomas Jaques, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 516 E. Nizhoni Blvd, Gallup, NM 87301 Phone: 505-722-1000 Fax: 928-697-4189 |