Individual
JENNA KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC, ATR
Contact information
Practice address
8500 EXECUTIVE PARK AVE STE 202, FAIRFAX, VA 22031-2253
(703) 852-7020
Mailing address
9615 CERALENE DR, FAIRFAX, VA 22032-1703
(757) 802-2221
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
11/06/2020
Last updated
11/06/2020
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