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Individual
NATHANIEL KELLEY
Active
Individual
NATHANIEL KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701010683
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0701010683
VA BOARD OF COUNSELING LICENSE NUMBER
VA
Enumeration date
07/28/2021
Last updated
07/28/2021
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