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1659862050
KELLY WALLIS
TIMONIUM, MD
NPI
1659862050
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor Professional
(Licence: MD LC8679)
Enumeration Date
2018-05-22
Last Update Date
2018-05-22
Business Address
KELLY WALLIS LCPC
9475 DEERECO RD STE 410
TIMONIUM, MD 21093-2124
Phone number: 410-560-6135
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Mailing Address
KELLY WALLIS LCPC
PO BOX 616
FINKSBURG, MD 21048-0616
Phone number: 410-998-3920
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