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Individual

SUSAN E KELLY

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
PHD, LMHC

Contact information

Practice address
5264 COUNCIL ST NE, STE 400, CEDAR RAPIDS, IA 52402-2471
(319) 398-6694
(319) 369-4673
Mailing address
PO BOX 1824, CEDAR RAPIDS, IA 52406-1824
(319) 369-4505
(319) 369-4677

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
00408
IA

Other

Enumeration date
03/31/2006
Last updated
07/08/2007
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