Organization
SD KELLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON KELLY (OWNER)
(706) 389-0974
Entity
Organization
Contact information
Practice address
1150 S MILLEDGE AVE STE 4, ATHENS, GA 30605-6723
(706) 389-0974
Mailing address
1150 S MILLEDGE AVE STE 4, ATHENS, GA 30605-6723
(706) 389-0974
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
02/04/2025
Last updated
02/04/2025
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