NPI | 1316391600 |
---|---|
Professional Name | PEG KELLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401015337) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401015337) |
Enumeration Date | 2016-04-22 |
Last Update Date | 2019-06-20 |