| Doctor Name: | MS. CAROL KELLY |
| NPI Number: | 1780644542 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CPC |
| License Number: | 5855788-6009 |
| Business Practice Address: | 7370 Creek Rd Suite 102 Sandy, UT - 840936105 |
| Business Phone Number: | 8015427060 |
| Business Fax Number: | 8015427061 |
| Mailing Address: | 1044 E 400 S, Apt 504a SALT LAKE CITY |
| State: | UT |
| Postal Code: | 841023152 |
| Phone Number: | 8013477027 |
| Fax Number: | 8015427061 |
| NPI Enumeration Date: | 03/24/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 5855788-6009 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| 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 |