Individual
KELLY HA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
13000 HARBOR CENTER DR STE 302, WOODBRIDGE, VA 22192-2847
(316) 300-9134
Mailing address
9583 NITTANY DR APT 102, MANASSAS, VA 20110-7024
(316) 300-9134
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/12/2022
Last updated
07/12/2022
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