Individual
SHAUN PATRICK KELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
111 DOLLY ST, GRAY, GA 31032-5307
(478) 227-9430
Mailing address
PO BOX 818, GRAY, GA 31032-0818
(478) 227-9430
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT001131
GA
Other
Enumeration date
01/22/2013
Last updated
02/12/2013
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