| Doctor Name: | DIANA LYNN KELSEY |
| NPI Number: | 1740514074 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCP |
| License Number: | LPC-4187 |
| Business Practice Address: | 14 Emerson Ln Kellogg, ID - 838372454 |
| Business Phone Number: | 2087830660 |
| Business Fax Number: | |
| Mailing Address: | 14 Emerson Ln, KELLOGG |
| State: | ID |
| Postal Code: | 838372454 |
| Phone Number: | 2087830660 |
| Fax Number: | |
| NPI Enumeration Date: | 09/18/2009 |
| NPI Last Update Date: | 09/18/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LPC-4187 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |