Individual
MRS. KELLY MICHELLE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
4607 CHARLOTTE HWY STE 18, LAKE WYLIE, SC 29710-8149
(803) 630-3247
Mailing address
3022 OAKMERE RD, WAXHAW, NC 28173-6042
(704) 604-7196
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A16324
NC
Other
Enumeration date
02/02/2021
Last updated
02/02/2021
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