Individual
DR. KELLY CARSON SOUZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY D
Contact information
Practice address
6411 STABLE CROSS TRL, CASTLE PINES, CO 80108-9553
(619) 884-7578
Mailing address
6411 STABLE CROSS TRL, CASTLE PINES, CO 80108-9553
(161) 988-4757
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0005475
CO
106H00000X
Marriage & Family Therapist
IMF50814
CA
Other
Enumeration date
02/02/2007
Last updated
02/01/2022
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