Individual
KELLY LOUIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
821 GRAND AVENUE PKWY, SUITE 102, PFLUGERVILLE, TX 78660-2196
(512) 585-8087
Mailing address
213 BALDWIN ST, HUTTO, TX 78634-5394
(512) 585-8087
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
73458
TX
Other
Enumeration date
10/06/2016
Last updated
10/06/2016
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