Provider Information for 1750533105
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JESSICA EVE KELLEY LMFT
Sex: Female
NPI: 1750533105
Last Updated: 2020-07-30
Certification Date: 2020-07-30
Certification Date: 2020-07-30
Details
| Name | Value | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1750533105 | ||||||||||||||
| Enumeration Date | 2008-10-16 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | NO | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | 10455 FRANKLIN LN WILMER, AL 36587-9336 United States Phone: 423-605-7632 | Fax: | ||||||||||||||
| Primary Practice Address | 10455 FRANKLIN LN WILMER, AL 36587-9336 United States Phone: 423-605-7632 | Fax: | ||||||||||||||
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