Individual
KELSEY COLLEEN MCGONIGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3835 CAPE LANDING DR APT T, MYRTLE BEACH, SC 29588-1129
(215) 287-3663
Mailing address
3835 CAPE LANDING DR APT T, MYRTLE BEACH, SC 29588-1129
(215) 287-3663
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
RBT-20-145344
SC
Other
Enumeration date
03/25/2021
Last updated
03/25/2021
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