Individual
MRS. KELLEY LYNN WHITECOTTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 CROWN POINT CIR, GRASS VALLEY, CA 95945
(530) 265-1437
Mailing address
500 CROWN POINT CIR, GRASS VALLEY, CA 95945-9561
(530) 470-2425
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
167G00000X
Licensed Psychiatric Technician
Primary
PT40257
CA
Other
Enumeration date
05/20/2016
Last updated
01/31/2017
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