Individual
MRS. CANDICE LA'NAE KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
1340 S WALDRON RD, FORT SMITH, AR 72903-2556
(479) 452-5040
Mailing address
PO BOX 23070, BARLING, AR 72923-0070
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
05/28/2014
Last updated
08/12/2019
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