Individual
MS. KELLI LEE MISTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA LLPC
Contact information
Practice address
204 S MACOMB ST STE 7, MONROE, MI 48161-2121
(734) 265-6749
Mailing address
435 LAVENDER ST, MONROE, MI 48162-2818
(734) 261-6749
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6401019064
MI
101YM0800X
Mental Health Counselor
Primary
6451019064
MI
Other
Enumeration date
02/15/2021
Last updated
02/08/2022
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