| NPI | 1093797060 |
|---|---|
| Former Name | KATIE R. KELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO 09924585) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VA 0904016363) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2026-08-05 |