Individual
MR. BARRY DEAN KELLEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CBHCM
Contact information
Practice address
902 ASHTON COVE TER, JACKSONVILLE, FL 32218-6126
(561) 713-4766
Mailing address
902 ASHTON COVE TER, JACKSONVILLE, FL 32218-6126
(561) 713-4766
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/29/2024
Last updated
03/29/2024
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