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Individual
KELLIE CALDERON
Active
Individual
KELLIE CALDERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
178.012283
IL
101YM0800X
Mental Health Counselor
Primary
180.012970
IL
101YP2500X
Professional Counselor
178012283
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417490681
NPI 1 NUMBER
IL
Enumeration date
11/21/2016
Last updated
06/23/2020
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