Individual
MRS. CAROLYN DARLENE KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRADC
Contact information
Practice address
760 S KINGSHIGHWAY ST, CAPE GIRARDEAU, MO 63703-7630
(573) 335-4333
(573) 335-4345
Mailing address
760 S KINGSHIGHWAY ST, CAPE GIRARDEAU, MO 63703-7630
(573) 335-4333
(573) 335-4345
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2708
MO
Other
Enumeration date
01/30/2019
Last updated
01/30/2019
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