Individual
AMELIA KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.C
Contact information
Practice address
2102 GARNER ROAD, RALEIGH, NC 27610
(919) 832-7351
Mailing address
2102 GARNER RD, SUITE 113, RALEIGH, NC 27610
(919) 832-7351
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
7483
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101Y00000X
—
NC
Enumeration date
09/02/2009
Last updated
02/27/2012
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