Individual
KELLY POWELL MATHERNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
101 COUNTRY VILLAGE DR, RACELAND, LA 70394-2009
(985) 688-4247
Mailing address
101 COUNTRY VILLAGE DR, RACELAND, LA 70394-2009
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5577
LA
Other
Enumeration date
01/09/2018
Last updated
01/09/2018
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