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Individual
SHANE RYAN KELSEY
Active
Individual
SHANE RYAN KELSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-8949
ID
Other
Enumeration date
06/28/2022
Last updated
06/28/2022
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