Individual
MS. KELLY DIANTHA ESTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1504 SPRINGHILL AVE, MOBILE, AL 36604-3207
(251) 709-6964
Mailing address
PO BOX 1002, SATSUMA, AL 36572-1002
(251) 709-6964
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2034C
AL
Other
Enumeration date
10/23/2008
Last updated
10/23/2008
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