| Kelly E Redwine Lpc Llc | |
|
300 Broadway Ave Braselton GA 30517 | |
| (770) 695-7501 | |
| Not Available |
| Full Name | Kelly E Redwine Lpc Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 300 Broadway Ave, Braselton, Georgia |
| Authorized Official Name and Position | Kelly Redwine (OWNER) |
| Authorized Official Contact | 7706957501 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly E Redwine Lpc Llc Po Box 637 Braselton GA 30517-0011 Ph: () - | Kelly E Redwine Lpc Llc 300 Broadway Ave Braselton GA 30517 Ph: (770) 695-7501 |
| NPI Number | 1093304297 |
|---|---|
| Provider Enumeration Date | 01/12/2021 |
| Last Update Date | 10/28/2021 |
| Certification Date | 10/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093304297 | NPI | - | NPPES |
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