KIRK DOUGLAS KELLY

BERKELEY, CA
NPI1225444201
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2014-07-10
Last Update Date2014-07-10
Business Address
Mr. KIRK DOUGLAS KELLY
1931 CENTER ST
BERKELEY, CA 94704-1105
Phone number: 408-613-0770
Mailing Address
Mr. KIRK DOUGLAS KELLY
1931 CENTER ST
BERKELEY, CA 94704-1105
Phone number: 408-613-0770