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1104297928
KELLY CARLL
SAN DIEGO, CA
NPI
1104297928
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: HI 4020)
Enumeration Date
2015-10-20
Last Update Date
2015-10-20
Business Address
-- KELLY CARLL LCSW
3350 LA JOLLA VILLAGE DR # 122
SAN DIEGO, CA 92161-0002
Phone number: 619-497-8929
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Mailing Address
-- KELLY CARLL LCSW
3350 LA JOLLA VILLAGE DR # 122
SAN DIEGO, CA 92161-0002
Phone number:
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