| NPI | 1689665788 |
|---|---|
| Former Name | KELLY LYNN MAHONEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2018-07-11 |