Individual
JACQUELYN KELLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1855 AMES BLVD, MARRERO, LA 70072-3429
(504) 214-0072
Mailing address
1825 HOPE ST, NEW ORLEANS, LA 70119-1307
(504) 952-3658
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11616
LA
Other
Enumeration date
03/24/2016
Last updated
05/23/2016
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