Individual
KATHY JEAN KELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC NCC
Contact information
Practice address
5 A MEDICAL LANE, CONWAY, AR 72034
(501) 764-4400
(401) 764-0049
Mailing address
2 LAURA LANE, CONWAY, AR 72034
(501) 764-4400
(501) 764-0049
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P0411050
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5Y153
ABCBS
AR
Enumeration date
08/30/2006
Last updated
07/08/2007
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