| NPI | 1821504861 |
|---|---|
| Former Name | CASEY L. KELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-12-27 |
| Last Update Date | 2021-08-18 |