| NPI | 1508983065 |
|---|---|
| Former Name | KELLY ANN YEAGLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MT 869LCSW) |
| Additional Taxonomies | 104100000X Social Worker (Licence: PA PA123419) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2023-11-27 |