Individual
KELLYE WILHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., LPC, LCDC
Contact information
Practice address
410 IRONTON AVE, LUBBOCK, TX 79416-4102
(806) 441-8823
Mailing address
410 IRONTON AVE, LUBBOCK, TX 79416-4102
(806) 441-8823
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
73937
TX
101YA0400X
Addiction (Substance Use Disorder) Counselor
13441
TX
Other
Enumeration date
03/31/2017
Last updated
03/31/2017
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