Individual
MRS. KELLY L RICHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LISW-CP
Contact information
Practice address
2021 BRIDGEMILL DR UNIT 104, FORT MILL, SC 29707-9209
(803) 336-1618
Mailing address
6426 STIRLING LN, FORT MILL, SC 29707-5908
(803) 336-1618
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12430
SC
1041C0700X
Clinical Social Worker
C005213
NC
Other
Enumeration date
08/24/2006
Last updated
03/24/2020
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