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Individual

KELLI MCKINNON THIELBAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
115 CONNIE WRIGHT RD, IRMO, SC 29063-8764
(803) 476-4413
Mailing address
115 CONNIE WRIGHT RD, IRMO, SC 29063-8764

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
203279
SC

Other

Enumeration date
06/10/2013
Last updated
06/10/2013
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