Individual
DR. KELLY CARL FELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, LCSW
Contact information
Practice address
537 W 2600 S, SUITE 203, BOUNTIFUL, UT 84010-7779
(801) 809-1049
Mailing address
1048 E FAIRWAY DR, NORTH SALT LAKE, UT 84054-3056
(801) 809-1049
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7057775-3501
UT
Other
Enumeration date
07/12/2011
Last updated
07/14/2011
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