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Individual

CORLETTE GANTT KELLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
1275 SHILOH RD NW STE 3030, KENNESAW, GA 30144-7186
(470) 296-1775
Mailing address
1275 SHILOH RD NW STE 3030, KENNESAW, GA 30144-7186
(470) 296-1775

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC009229
GA

Other

Enumeration date
01/29/2024
Last updated
01/29/2024
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