Individual
MS. KELYSHIA JEWAN KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLPA
Contact information
Practice address
57997 BARROW ST, PLAQUEMINE, LA 70764-4107
(225) 241-8876
Mailing address
57997 BARROW ST, PLAQUEMINE, LA 70764-4107
(225) 241-8876
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
235Z00000X
Speech-Language Pathologist
6423
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255705828
—
LA
Enumeration date
05/19/2017
Last updated
07/21/2022
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