Individual
MS. KELLY LORRAINE SHIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1738 S MARTINSON, WICHITA, KS 67213-5799
(316) 293-9547
(316) 691-8473
Mailing address
1738 S MARTINSON, WICHITA, KS 67213-5799
(316) 293-9547
(316) 691-8473
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1942
KS
Other
Enumeration date
08/23/2007
Last updated
09/05/2012
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