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1104244474
KELLEY WILSON
BRADENTON, FL
NPI
1104244474
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: FL MH7200)
Enumeration Date
2014-04-02
Last Update Date
2014-04-02
Business Address
-- KELLEY WILSON
5131 MANATEE AVE W
BRADENTON, FL 34209-3740
Phone number: 941-792-0802
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Mailing Address
-- KELLEY WILSON
7406 LOBLOLLY BAY TRL
LAKEWOOD RANCH, FL 34202-4167
Phone number: 941-238-8180
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