Individual
COLLEEN M KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
537 SE ALDER ST, PORTLAND, OR 97214-2231
(503) 972-9633
(503) 972-9636
Mailing address
3910 SE STARK ST, PORTLAND, OR 97214-3241
(503) 235-8655
(503) 239-6233
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C1691
OR
Other
Enumeration date
03/05/2007
Last updated
09/19/2014
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