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AMANDA H KELLEY LCSW
Clinical >> Social Worker >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1023587524
Individual Registrant: AMANDA H KELLEY LCSW
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
110 N DREW ST STAR CITY, AR 71667 US
Tel: 870-628-5110 Fax: 855-854-6281
Tel: 870-628-5110 Fax: 855-854-6281
Contact information for business:
PO BOX 509 DERMOTT, AR 71638-0509 US
Tel: 870-538-5414 Fax: 870-538-5412
Tel: 870-538-5414 Fax: 870-538-5412
Registration Information:
NPI: 1023587524
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 1041C0700X | Behavioral Health & Social Service Providers Social Worker Clinical | AR |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
