Individual
MRS. KELLY RENAE SUKOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., I.M.F.T.
Contact information
Practice address
267 S. MARINE CORPS DRIVE, SUITE 2D, TAMUNING, GU 96913
(671) 646-7972
(671) 647-7972
Mailing address
267 S. MARINE CORPS DRIVE, SUITE 2D, TAMUNING, GU 96913
(671) 646-7972
(671) 647-7972
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
IMF74
GU
Other
Enumeration date
03/15/2010
Last updated
03/15/2010
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