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Individual
MISS KELLY MOZELLE BOLLINGER
Active
Individual
MISS KELLY MOZELLE BOLLINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED. LPC CACII
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
5043
SC
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1102244
SC
101YM0800X
Mental Health Counselor
5043
SC
101YP2500X
Professional Counselor
5043
SC
Other
Enumeration date
11/07/2012
Last updated
09/04/2025
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