Individual
KELLY JURAE BANKS BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
600 VILLAGE TRACE NE, BLDG 23, SUITE 100, MARIETTA, GA 30067
(770) 971-3303
Mailing address
4611 RIVER HILL CIR, ELLENWOOD, GA 30294-1884
(678) 920-1151
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY004757
GA
Other
Enumeration date
03/30/2021
Last updated
04/17/2025
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