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1093078867
DEBRA J KELLY
SANTA ROSA, CA
NPI
1093078867
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: CA MFC19530)
Enumeration Date
2012-06-18
Last Update Date
2012-06-18
Business Address
Ms. DEBRA J KELLY MFT
114 SOTOYOME ST
SANTA ROSA, CA 95405-4804
Phone number: 707-569-0459
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Mailing Address
Ms. DEBRA J KELLY MFT
114 SOTOYOME ST
SANTA ROSA, CA 95405-4804
Phone number: 707-569-0459
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