Individual
DR. SHANNON RAE KELLEY-POULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1216 N PROSPECT AVE, MILWAUKEE, WI 53202-3014
(414) 271-9791
(414) 271-1299
Mailing address
1216 N PROSPECT AVE, MILWAUKEE, WI 53202-3014
(414) 271-9791
(414) 271-1299
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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