| Doctor Name: | MRS. SUZANNE AUTREY KELLY |
| NPI Number: | 1366420192 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC,LCAS,CEAP,LEAP |
| License Number: | 60 |
| Business Practice Address: | 110 W Elm St Yadkinville, NC - 270551758 |
| Business Phone Number: | 3366773991 |
| Business Fax Number: | 3366771359 |
| Mailing Address: | 120 Walnut Ave, YADKINVILLE |
| State: | NC |
| Postal Code: | 270555752 |
| Phone Number: | 3364661053 |
| Fax Number: | 3366771359 |
| NPI Enumeration Date: | 01/03/2006 |
| NPI Last Update Date: | 08/27/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 60 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |