Individual
JEANETTE ANN KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
114 5TH AVE FL 2, NEW YORK, NY 10011-5611
(609) 668-1186
Mailing address
4 SANDSTONE CT, MEDFORD, NJ 08055-8502
(609) 668-1186
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00931100
NJ
Other
Enumeration date
04/07/2023
Last updated
04/07/2023
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