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Individual

KELLI DAWN BURNS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPCC

Contact information

Practice address
1045 KLOTZ RD, BOWLING GREEN, OH 43402-4820
(419) 352-7588
(419) 354-4977
Mailing address
3445 SWAN RIDGE LN, MAUMEE, OH 43537-9413
(419) 491-0830

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
C0008147
OH
101YP2500X
Professional Counselor
Primary
E.1800918
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C0008147
STATE OF OHIO COUNSELOR AND SOCIAL WORKER BOARD
OH
01
E.1800918
STATE OF OHIO COUNSELOR, SOCIAL WORKER, MARRIAGE AND FAMILY THERAPIST BOARD
OH
Enumeration date
05/13/2011
Last updated
11/01/2018
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