| NPI | 1538792387 |
|---|---|
| Former Name | KELLY BAILEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC CO13652) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 130921) |
| 1041C0700X Social Worker, Clinical (Licence: IL 149.022732) | |
| Enumeration Date | 2020-02-20 |
| Last Update Date | 2021-04-05 |