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General NPI Number Information
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NPI Number | 1376051771
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Entity Type | Individual
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Provider Name | KELLY LEE OZELSKI LMFT
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Gender | Female
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Dates
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Enumeration Date | 01/19/2018
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 752 WILLOW ST
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City | LEBANON
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State | PA
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Zip | 17046-5066
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Country | US
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Telephone | 717-926-6760
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Fax | 877-250-4210
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Provider Business Mailing Address
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Address Line | 160 S 22ND ST
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City | LEBANON
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State | PA
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Zip | 17042-2559
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Country | US
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Telephone | 717-926-6760
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MF000948
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License Number State | PA
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