Individual
KELSEY JEFFERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2711 COLONIAL DR, COLUMBIA, SC 29203-6818
(803) 726-9300
Mailing address
2711 COLONIAL DR, COLUMBIA, SC 29203-6818
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
SC
1041C0700X
Clinical Social Worker
Primary
14249
SC
Other
Enumeration date
11/09/2017
Last updated
05/26/2021
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