Individual
MRS. KELLEY HAVILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT, LMHC
Contact information
Practice address
3925 HAGAN ST, 203, BLOOMINGTON, IN 47401
(812) 334-0001
(812) 334-0001
Mailing address
3925 HAGAN ST, 203, BLOOMINGTON, IN 47401-8556
(812) 333-9895
(812) 334-0001
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
39001493A
IN
106H00000X
Marriage & Family Therapist
Primary
35001502A
IN
Other
Enumeration date
02/06/2007
Last updated
07/31/2018
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