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Individual

KELLI-LEE KIMONE HARFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
1605 CHANTILLY DR NE STE 105, ATLANTA, GA 30324-3267
(404) 785-5437
Mailing address
1605 CHANTILLY DR NE STE 105, ATLANTA, GA 30324-3267
(404) 785-5437

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
2765-57
WI
103TC0700X
Clinical Psychologist
Primary
PSY004160
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2765-57
PSYCHOLOGIST
WI
Enumeration date
10/15/2008
Last updated
03/17/2018
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