Individual
KELLY CARLTON CONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
509 OLD GREAT NECK RD STE 203, VIRGINIA BEACH, VA 23454-3358
(757) 520-1312
Mailing address
3101 MAGIC HOLLOW BLVD, VIRGINIA BEACH, VA 23453-3010
(757) 639-2218
(866) 594-3899
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0704015413
VA
106S00000X
Behavior Technician
RBT-20-137898
VA
Other
Enumeration date
10/03/2020
Last updated
02/12/2024
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