| NPI | 1124416052 |
|---|---|
| Former Name | KELLY LYNN FOX |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801105550) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MI 6801105550) |
| Enumeration Date | 2014-12-30 |
| Last Update Date | 2024-09-25 |