Individual
SHANE KELSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LGPC
Contact information
Practice address
5022 CAMPBELL BLVD STE L, NOTTINGHAM, MD 21236-4969
(443) 442-1568
(443) 442-1569
Mailing address
5022 CAMPBELL BLVD STE L, NOTTINGHAM, MD 21236-4969
(443) 442-1568
(443) 442-1569
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LGP8575
MD
Other
Enumeration date
04/17/2018
Last updated
04/17/2018
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