Individual
MRS. KIMBERLY A KELLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS/LPC
Contact information
Practice address
3865 BEAVER RD, MUNFORD, TN 38058-4277
(901) 586-6317
(901) 296-0041
Mailing address
PO BOX 170, BURLISON, TN 38015-0170
(019) 586-6317
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4022
TN
101YP2500X
Professional Counselor
P0802017
AR
Other
Enumeration date
10/03/2006
Last updated
11/11/2021
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