Provider Demographics
NPI:1689233892
Name:REHM, KELLEY PHILLIPS (MS LMFT)
Entity Type:Individual
Prefix:MRS
First Name:KELLEY
Middle Name:PHILLIPS
Last Name:REHM
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4210 LOMAC ST
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-2817
Mailing Address - Country:US
Mailing Address - Phone:334-425-8063
Mailing Address - Fax:
Practice Address - Street 1:4210 LOMAC ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-2817
Practice Address - Country:US
Practice Address - Phone:334-425-8063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALL429106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist