Southern, Kelly Anne
Southern, Kelly Anne is an individual health care provider with primary practice located at 612 Se Jackson St Ste 11 , Roseburg OR 97470-4956. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Southern, Kelly Anne can be contacted via phone (541) 464-6455.Contact Information
Primary practice address
612 Se Jackson St Ste 11
Roseburg OR 97470-4956
Phone: (541) 464-6455
Fax: (541) 464-6457
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 4143 | Oregon |
Profile Details
| NPI number | 1871638296 |
|---|---|
| LBN Legal business name | Southern, Kelly Anne |
| Credentials | MSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 21st, 2007 |
| Last updated | Apr 15th, 2021 - about 3 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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