Individual
OPHELIA KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
2941 TERRY RD, JACKSON, MS 39212-3073
(601) 373-0566
(601) 373-0566
Mailing address
105 MEADOWVIEW CIR, CLINTON, MS 39056-5907
(601) 608-8680
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1820
MS
104100000X
Social Worker
W0803
MS
Other
Enumeration date
11/20/2012
Last updated
08/22/2016
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