Individual
ALICE KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
12148 JOLLYVILLE RD APT 1301, AUSTIN, TX 78759-2240
(504) 270-3834
Mailing address
12148 JOLLYVILLE RD APT 1301, AUSTIN, TX 78759-2240
(504) 270-3834
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
203732
TX
Other
Enumeration date
04/04/2022
Last updated
08/24/2022
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