Individual
KIMBERLY MICHELLE KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
15 SW COLORADO AVE, STE. 130, BEND, OR 97702-1150
(541) 480-3665
(541) 550-3887
Mailing address
PO BOX 1225, BEND, OR 97709-1225
(541) 480-3665
(541) 550-3887
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C1101
OR
Other
Enumeration date
06/20/2009
Last updated
07/19/2016
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