| NPI | 1114312303 |
|---|---|
| Former Name | JAMIE M KELLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: ID LCSW 497) |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2015-10-02 |