| NPI | 1164715918 |
|---|---|
| Former Name | PATRICIA MARY JEAN KELLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149002118) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO 2011003368) |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2023-05-11 |