Organization
KATI CONNELLY PHD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHLEEN ELIZABETH CONNELLY PHD, HSP-P (INCORPORATOR, STOCKHOLDER)
(703) 477-4969
Entity
Organization
Contact information
Practice address
895 STATE FARM RD STE 504, BOONE, NC 28607-4689
(703) 477-4969
Mailing address
PO BOX 219, BOONE, NC 28607-0219
(703) 477-4969
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
5050
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1306386677
NPPES
NC
Enumeration date
06/18/2018
Last updated
06/18/2018
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