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General NPI Number Information
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NPI Number | 1194413807
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Entity Type | Individual
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Provider Name | KELSEY SCOTT MSW
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Gender | Female
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Dates
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Enumeration Date | 05/01/2023
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Last Update Date | 05/01/2023
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Provider Practice Location Address
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Address Line | 3395 SIXES RD UNIT 2302
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City | CANTON
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State | GA
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Zip | 30114-9125
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Country | US
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Telephone | 770-224-7245
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Fax |
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Provider Business Mailing Address
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Address Line | 313 HICKORY RUN WAY
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City | CANTON
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State | GA
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Zip | 30114-0005
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Country | US
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Telephone | 530-305-6128
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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