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1033541933
MICHELE KELLY
BLACKFOOT, ID
NPI
1033541933
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: ID LCSW-30317)
Enumeration Date
2013-08-01
Last Update Date
2014-04-16
Business Address
-- MICHELE KELLY LCSW
295 CENTENNIAL STREET
BLACKFOOT, ID 83221-2700
Phone number: 208-680-4086
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Mailing Address
-- MICHELE KELLY LCSW
295 CENTENNIAL ST
BLACKFOOT, ID 83221-3963
Phone number: 208-680-4086
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