| NPI | 1902967227 |
|---|---|
| Former Name | MICHAEL B. KELLY-DEFREECE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 928) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE P-939) |
| 101YM0800X Counselor, Mental Health (Licence: NE 2718) | |
| 101YP2500X Counselor, Professional (Licence: NE 1446) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2019-12-04 |