| Kati Connelly Phd Pllc | |
|
895 State Farm Rd Ste 504 Boone NC 28607-4689 | |
| (703) 477-4969 | |
| Not Available |
| Full Name | Kati Connelly Phd Pllc |
|---|---|
| Speciality | Psychologist - Counseling |
| Location | 895 State Farm Rd Ste 504, Boone, North Carolina |
| Authorized Official Name and Position | Kathleen Elizabeth Connelly (INCORPORATOR, STOCKHOLDER) |
| Authorized Official Contact | 7034774969 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kati Connelly Phd Pllc Po Box 219 Boone NC 28607-0219 Ph: (703) 477-4969 | Kati Connelly Phd Pllc 895 State Farm Rd Ste 504 Boone NC 28607-4689 Ph: (703) 477-4969 |
| NPI Number | 1265926893 |
|---|---|
| Provider Enumeration Date | 06/18/2018 |
| Last Update Date | 06/18/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265926893 | NPI | - | NPPES |
| 1306386677 | Other | NC | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | 5050 (North Carolina) | Primary |
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