Individual
JENNIFER FORD KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED, EDS, LPC
Contact information
Practice address
316 W MILLBROOK RD, SUITE 101, RALEIGH, NC 27609-4478
(919) 345-8965
Mailing address
316 W MILLBROOK RD, SUITE 101, RALEIGH, NC 27609-4478
(919) 345-8965
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5092
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6103034
—
NC
Enumeration date
07/05/2006
Last updated
07/12/2011
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