Individual
KELLI CHURCHILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5001 HIGHWAY 190 EAST SERVICE RD STE B1, COVINGTON, LA 70433-4999
(985) 630-8350
(985) 867-3438
Mailing address
1925 AMERICA ST, MANDEVILLE, LA 70448-3802
(985) 630-8350
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7735
LA
Other
Enumeration date
05/07/2007
Last updated
01/30/2012
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