Individual
BRANDI KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
20 N 11TH ST, BEAUMONT, TX 77702-2211
(409) 201-4148
Mailing address
4630 COLLIER ST APT 416, BEAUMONT, TX 77706-7071
(409) 201-4148
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
66745
TX
Other
Enumeration date
04/03/2012
Last updated
04/03/2012
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