Individual
LAUREL C KELSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7191 WAGNER WAY, SUITE 301, GIG HARBOR, WA 98335-0115
(253) 514-8076
(253) 514-8078
Mailing address
PO BOX 97115, LAKEWOOD, WA 98497-0115
(253) 588-7911
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW00007524
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LW00007524
PROFESSIONAL LICENSE
WA
Enumeration date
02/02/2009
Last updated
02/20/2013
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