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Individual

MRS. THOMASENA SANDERS KELLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, LPCA, ADC

Contact information

Practice address
764 SAINT ANDREWS BLVD, CHARLESTON, CHARLESTON, SC 29407
(843) 405-1122
Mailing address
343 SOUTHPORT DR, SUMMERVILLE, SC 29483-7080
(843) 345-3394

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1808318
SC
101YM0800X
Mental Health Counselor
Primary
7962
SC

Other

Enumeration date
11/10/2020
Last updated
05/27/2023
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