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Individual
KELLY JO WASHAM
Active
Individual
KELLY JO WASHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CADC II
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
T3092
OR
Other
Enumeration date
06/02/2010
Last updated
09/15/2025
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