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Individual
MRS. KAY KELLY ANDERSON
Active
Individual
MRS. KAY KELLY ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LCPC2976
ID
106H00000X
Marriage & Family Therapist
Primary
LMFT2977
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806910400
—
ID
05
—
806983200
—
ID
05
—
806984800
—
ID
05
—
807346100
—
ID
05
—
807384700
—
ID
Enumeration date
04/24/2007
Last updated
06/08/2020
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