| NPI | 1831959105 |
|---|---|
| Former Name | MARISA BRITTANY KELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 80730) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 34366) |
| Enumeration Date | 2024-03-21 |
| Last Update Date | 2025-08-30 |