Individual
KELLY BROYLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
2200 N PATTERSON ST, SUITE D, VALDOSTA, GA 31602-2597
(229) 244-1707
Mailing address
2200 N PATTERSON ST, SUITE D, VALDOSTA, GA 31602-2597
(229) 244-1707
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT001514
GA
Other
Enumeration date
11/08/2016
Last updated
11/08/2016
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