Mia Tanya Stula Kellam, LAC
NPI #1417114240 in Bound Brook, New Jersey
Provider Information
- NPI Number
- 1417114240
- Entity Type
- Individual
- Name
- Mia Tanya Stula Kellam, LAC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor - Mental Health
- Credential
- LAC
- Enumeration Date
- May 20, 2008
- Last Updated
- May 20, 2008
Practice Location
- Address
- 339 W 2ND ST
- City
- Bound Brook
- State
- New Jersey
- ZIP Code
- 08805-1833
- Phone
- (732) 356-1082
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
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