Individual
MS. KELLY BLANCHE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.C.
Contact information
Practice address
3603 N 7TH AVE, PHOENIX, AZ 85013-3638
(602) 234-1935
Mailing address
15821 E KIM DR, FOUNTAIN HILLS, AZ 85268-1827
(480) 734-7870
(480) 837-4957
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC 10451
AZ
Other
Enumeration date
11/15/2006
Last updated
07/08/2007
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