| NPI | 1992215271 |
|---|---|
| Former Name | KELLY D CHANCE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2020000664) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MO 2017017986) |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2021-11-10 |