Individual
MRS. KELLY MCGINITY CHILDRESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED, NCC, LPC
Contact information
Practice address
220 SUGAR CREEK RD, GREER, SC 29650-3023
(864) 593-0309
Mailing address
220 SUGAR CREEK RD, GREER, SC 29650-3023
(864) 593-0309
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
4936
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
301100
—
SC
Enumeration date
12/27/2006
Last updated
09/08/2016
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