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1215699483
BLAKE JILLIAN KELLUM
CHARLOTTE, NC
NPI
1215699483
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: NC A16773)
Enumeration Date
2021-10-06
Last Update Date
2022-08-11
Business Address
BLAKE JILLIAN KELLUM LCMHCA
6849 FAIRVIEW RD STE 702
CHARLOTTE, NC 28210-3393
Phone number: 704-350-5324
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Mailing Address
BLAKE JILLIAN KELLUM LCMHCA
6849 FAIRVIEW RD STE 702
CHARLOTTE, NC 28210-3393
Phone number: 704-350-5324
Copy
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