Individual
KIMBERLY ANN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH. D., MA, MED
Contact information
Practice address
315 5TH AVE, FAIRBANKS, AK 99701-5025
(907) 374-7776
(800) 988-7650
Mailing address
315 5TH AVE, FAIRBANKS, AK 99701-5025
(907) 374-7776
(800) 988-7650
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/06/2021
Last updated
10/06/2021
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