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Individual

MRS. KELLY CRUSE RIFE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCMHC

Contact information

Practice address
107 KILSON DR STE 202, MOORESVILLE, NC 28117-8183
(704) 660-8321
Mailing address
155 ISLAND VIEW RD, STATESVILLE, NC 28677-2051
(704) 528-4285
(704) 528-4285

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
987
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
71418
BCBS
NC
Enumeration date
06/14/2007
Last updated
09/10/2020
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