Individual
KELLY MOULTRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1850 PINEVIEW DR, COLUMBIA, SC 29209-5085
(803) 783-0303
(803) 783-0955
Mailing address
2715 COLONIAL DR, COLUMBIA, SC 29203-6818
(803) 783-0303
(803) 783-0955
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
01/13/2014
Last updated
01/13/2014
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