Individual
KELLY KRISTINE ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1619 GRACE ST, WILMINGTON, NC 28401-3800
(919) 896-0214
Mailing address
1619 GRACE ST, WILMINGTON, NC 28401-3800
(919) 896-0214
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
05/27/2021
Last updated
01/10/2024
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