Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 83940 | TX |
NPI | 1003568395 |
---|---|
Provider Name | Kelley E Price |
First Address | Austin, TX 78704-2911 |
Second Address | Austin, TX 78704 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2022 |
Last Update Date | 19/01/2022 |