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Individual
MR. JAY DANIEL KELLEY
Active
Individual
MR. JAY DANIEL KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC LCDC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1219
TX
101YP2500X
Professional Counselor
Primary
10634
TX
Other
Enumeration date
10/27/2006
Last updated
06/08/2015
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