Organization
KELLIN, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY GRAVES PHD (OWNER)
(336) 355-6206
Entity
Organization
Contact information
Practice address
1175 REVOLUTION MILL DR STE 34L, GREENSBORO, NC 27405-5168
(336) 355-6206
Mailing address
1175 REVOLUTION MILL DR STE 34L, GREENSBORO, NC 27405-5168
(336) 355-6206
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3531
NC
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
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Other
Enumeration date
08/12/2016
Last updated
09/10/2024
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