Individual
KELLY WAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1745 THOMPSON BRIDGE RD, GAINESVILLE, GA 30501-1717
(770) 536-9903
Mailing address
1745 THOMPSON BRIDGE RD, GAINESVILLE, GA 30501-1717
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC014954
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPC014954
GA COMPOSITE BOARD OF PROFESSIONAL COUNSELORS
GA
Enumeration date
08/17/2022
Last updated
08/02/2024
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