Individual
KELLY M MICHAUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
345 W MEMORIAL DR, HINESVILLE, GA 31313-2413
(912) 456-2010
Mailing address
345 W MEMORIAL DR, HINESVILLE, GA 31313-2413
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003141299A
—
GA
01
—
12610067
CAQH
GA
Enumeration date
12/04/2009
Last updated
05/01/2025
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