Individual
KELLI MCAMIS WHITLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
1703 COUNTRY CLUB RD, SUITE 204, JACKSONVILLE, NC 28546-6008
(910) 347-3010
(910) 347-0740
Mailing address
1703 COUNTRY CLUB RD, SUITE 204, JACKSONVILLE, NC 28546-6008
(910) 347-3010
(910) 347-0740
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2445
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146A8
BC/BS
NC
05
—
6107511
—
NC
Enumeration date
07/13/2007
Last updated
05/08/2008
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