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1508510033
TRACY JUNEIL KELLY
STOCKTON, CA
NPI
1508510033
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CA 117056)
Additional Taxonomies
101Y00000X Counselor
Enumeration Date
2022-02-03
Last Update Date
2024-04-30
Business Address
TRACY JUNEIL KELLY
1212 N CALIFORNIA ST
STOCKTON, CA 95202-1552
Phone number: 209-468-8644
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Mailing Address
TRACY JUNEIL KELLY
PO BOX 2187
STOCKTON, CA 95201-2187
Phone number: 925-497-1737
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