Individual
KIMBERLEY S KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC, LMSW, IADC
Contact information
Practice address
310 W. MAIN ST, OTTUMWA, IA 52501
(641) 683-6747
(641) 683-6317
Mailing address
PO BOX 658, OTTUMWA, IA 52501-0658
(641) 683-6747
(641) 682-1924
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
001380
IA
104100000X
Social Worker
03163
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
228839
MIDLANDS CHOICE
IA
Enumeration date
11/18/2005
Last updated
05/08/2017
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