| NPI | 1750363263 |
|---|---|
| Other Name | KIM KELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 001380) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IA 03163) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2017-05-08 |