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AMANDA H KELLEY LCSW

Clinical >> Social Worker >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1023587524

Individual Registrant:
 AMANDA H KELLEY LCSW
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

Contact information for business:
PO BOX 509  DERMOTT, AR 71638-0509 US
Tel: 870-538-5414  Fax: 870-538-5412

Registration Information:
NPI: 1023587524
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1041C0700XBehavioral Health & Social Service Providers
Social Worker
Clinical
AR

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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