Provider Demographics
NPI:1841782034
Name:SALMONS, KELLY MICHELLE
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:MICHELLE
Last Name:SALMONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 LINCOLN PLZ
Mailing Address - Street 2:
Mailing Address - City:BRANCHLAND
Mailing Address - State:WV
Mailing Address - Zip Code:25506-9786
Mailing Address - Country:US
Mailing Address - Phone:304-824-3244
Mailing Address - Fax:304-824-3245
Practice Address - Street 1:29 LINCOLN PLZ
Practice Address - Street 2:
Practice Address - City:BRANCHLAND
Practice Address - State:WV
Practice Address - Zip Code:25506-9786
Practice Address - Country:US
Practice Address - Phone:304-824-3244
Practice Address - Fax:304-824-3245
Is Sole Proprietor?:No
Enumeration Date:2018-06-04
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor