Provider Demographics
NPI:1033482096
Name:ROLAND-KELLAR, LAURA KATHRYN (MA, LMHC)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:KATHRYN
Last Name:ROLAND-KELLAR
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18631 SE 61ST STREET RD
Mailing Address - Street 2:
Mailing Address - City:OCKLAWAHA
Mailing Address - State:FL
Mailing Address - Zip Code:32179-3459
Mailing Address - Country:US
Mailing Address - Phone:321-343-7675
Mailing Address - Fax:
Practice Address - Street 1:18631 SE 61ST STREET RD
Practice Address - Street 2:
Practice Address - City:OCKLAWAHA
Practice Address - State:FL
Practice Address - Zip Code:32179-3459
Practice Address - Country:US
Practice Address - Phone:321-343-7675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-21
Last Update Date:2024-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health