Individual
MS. CARLY KITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSP
Contact information
Practice address
2701 17TH ST, ROCK ISLAND, IL 61201-5351
(309) 779-2050
Mailing address
2701 17TH ST, ROCK ISLAND, IL 61201-5351
(309) 779-2050
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
IL
Other
Enumeration date
12/27/2016
Last updated
12/27/2016
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