Individual
KELLY E NOWOTNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
12319 WILLOW WILD DR STE B, AUSTIN, TX 78758-2725
(512) 470-3539
(512) 837-3131
Mailing address
8613 ROCK PIGEON DR, AUSTIN, TX 78729-8086
(512) 470-3539
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
64120
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208050902
—
TX
Enumeration date
02/24/2009
Last updated
08/06/2024
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