Provider Demographics
NPI:1275256836
Name:RHYNE, KELLY BORDEN (MSW, MDIV)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:BORDEN
Last Name:RHYNE
Suffix:
Gender:F
Credentials:MSW, MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 FAYETTEVILLE ROAD
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316
Mailing Address - Country:US
Mailing Address - Phone:404-486-9034
Mailing Address - Fax:
Practice Address - Street 1:1030 FAYETTEVILLE ROAD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30316
Practice Address - Country:US
Practice Address - Phone:404-486-9034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health