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1245465699
SAMANTHA ANNE KELLY
DIXON, IL
NPI
1245465699
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2009-05-28
Last Update Date
2009-05-28
Business Address
-- SAMANTHA ANNE KELLY BAMHP
325 IL ROUTE 2
DIXON, IL 61021-9118
Phone number: 815-284-6611
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Mailing Address
-- SAMANTHA ANNE KELLY BAMHP
114 E CHAMBERLIN ST
DIXON, IL 61021-2134
Phone number: 815-284-6611
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