Individual
JUSTIN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
7200 DESIARD ST, MONROE, LA 71203-3913
(504) 220-4811
Mailing address
7200 DESIARD ST, MONROE, LA 71203-3913
(504) 220-4811
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5670
LA
Other
Enumeration date
04/05/2016
Last updated
04/05/2016
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