Individual
MRS. K. MICHELLE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW, LPCC
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
C.1300607
OH
101YP2500X
Professional Counselor
Primary
E.1300607
OH
104100000X
Social Worker
S.0025386
OH
Other
Enumeration date
12/16/2013
Last updated
04/05/2016
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