Individual
AFI TINA ALINE KPELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
405 3RD AVE W UPPR, NEWARK, NJ 07107-3725
(973) 342-1668
Mailing address
405 3RD AVE W UPPR, NEWARK, NJ 07107-3725
(973) 342-1668
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
37AC00858700
NJ
Other
Enumeration date
02/27/2025
Last updated
02/27/2025
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