Individual
MISS ANITA MARIE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC, CAP
Contact information
Practice address
11254 58TH ST. N., PINELLAS PARK, FL 33782-2213
(727) 545-6477
(727) 545-6464
Mailing address
11254 58TH ST. N., PINELLAS PARK, FL 33782-2213
(727) 545-6477
(727) 545-6464
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
MH12836
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MH12836
LICENSE
FL
Enumeration date
12/04/2014
Last updated
12/04/2014
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