Individual
KELLI REVELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS, CSI
Contact information
Practice address
901 OLD MARS HILL HWY STE 3, WEAVERVILLE, NC 28787
(828) 645-3687
Mailing address
515 CLANTON RD, CHARLOTTE, NC 28217-1309
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-22735
NC
Other
Enumeration date
06/27/2016
Last updated
08/01/2018
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