| Doctor Name: | CAROLINA ANNA KELLENBERGER |
| NPI Number: | 1154625101 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS |
| License Number: | 9293 |
| Business Practice Address: | 8610 Brentwood Dr Ste B La Vista, NE - 681283377 |
| Business Phone Number: | 4023313232 |
| Business Fax Number: | 4023311557 |
| Mailing Address: | 8610 Brentwood Dr Ste B, LA VISTA |
| State: | NE |
| Postal Code: | 681283377 |
| Phone Number: | 4023313232 |
| Fax Number: | 4023311557 |
| NPI Enumeration Date: | 01/05/2011 |
| NPI Last Update Date: | 01/05/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 9293 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NE |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |