Most Relevant Information
Provider Data
| NPI Number: | 1003449802 |
| Provider Name: | KENT RYAN KELLEY |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | BBH-LCPC-LIC-11444 |
Most Important Dates
| Enumeration Date: | 02/20/2020 |
| Last Updated: | 02/20/2020 |
Provider Practice Location
306 ISLAND CIR
SARASOTA
FL
342421938
Practice Location Phone/Fax
| Phone: | 9413073592 |
| Fax: |
Provider Mailing Location
306 ISLAND CIR
SARASOTA
FL
342421938
Provider Mailing Phone/Fax
| Phone: | 9413073592 |
| Fax: |