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Individual

KRYSTAL DISTINCTION KELLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
10105 PLANK RD STE A, CLINTON, LA 70722-3707
(225) 244-7026
(225) 244-7028
Mailing address
10105 PLANK RD STE A, CLINTON, LA 70722-3707
(225) 244-7026
(225) 244-7028

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
05/16/2017
Last updated
05/16/2017
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