Individual
KELLY BARTLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APCC
Contact information
Practice address
924 EMERALD BAY RD STE A2, SOUTH LAKE TAHOE, CA 96150-6434
(530) 721-0359
Mailing address
924 EMERALD BAY RD STE A2, SOUTH LAKE TAHOE, CA 96150-6434
(530) 721-0359
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
APCC18207
CA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
04/26/2024
Last updated
12/16/2024
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