KELLY D DISTELRATH

PORT HURON, MI
NPI1598976375
Former NameKELLY D HADDEN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy103TC0700X Psychologist, Clinical
(Licence: MI  6361007549)
Additional Taxonomies101YM0800X Counselor, Mental Health
Enumeration Date2007-05-24
Last Update Date2021-03-03
Business Address
KELLY D DISTELRATH LLP
520 SUPERIOR ST
PORT HURON, MI 48060-3838
Phone number: 810-984-4202
Mailing Address
KELLY D DISTELRATH LLP
1340 PINECREST DR
FERNDALE, MI 48220-1608
Phone number: 586-258-0206