Individual
KELSY TIMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
143 SKATEWAY DR, FAYETTEVILLE, NC 28304-2640
(910) 864-6257
Mailing address
143 SKATEWAY DR, FAYETTEVILLE, NC 28304-2640
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
51053404
NC
Other
Enumeration date
12/23/2019
Last updated
12/23/2019
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