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Individual

KELLIE CAROSELLI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4807 SPICEWOOD SPRINGS RD BLDG 1, AUSTIN, TX 78759-8444
(512) 843-7665
Mailing address
6816 TELLURIDE TRL, AUSTIN, TX 78749-1791

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
78098
TX

Other

Enumeration date
05/07/2018
Last updated
05/07/2018
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