Kerllenevich, Mary Alston

Kerllenevich, Mary Alston is an sole proprietor health care provider with primary practice located at 1100 S Ponce De Leon Blvd Ste 1 , St Augustine FL 32084-6013. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Kerllenevich, Mary Alston can be contacted via phone (904) 824-7733.

Contact Information

Primary practice address
1100 S Ponce De Leon Blvd Ste 1 St Augustine FL 32084-6013
Phone: (904) 824-7733
Fax: (904) 829-9768
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PY7744 Florida
Behavioral Health & Social Service Providers / Clinical 103TC0700X PY7744 Florida

Profile Details

NPI number 1386713048
LBN Legal business name Kerllenevich, Mary Alston
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 7th, 2006
Last updated Aug 12th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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