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Individual

KELLY THELEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LLPC

Contact information

Practice address
57239 N MAIN ST, THREE RIVERS, MI 49093-9419
(269) 273-0030
Mailing address
2529 CHOPIN AVE, PORTAGE, MI 49024-6631

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401012890
MI

Other

Enumeration date
10/26/2016
Last updated
10/26/2016
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