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Individual
MS. KELLY WALSH
Active
Individual
MS. KELLY WALSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
I.1801129
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0364235
—
OH
01
—
184607
MEDICARE GROUP NUMBER
KY
Enumeration date
07/06/2006
Last updated
01/03/2020
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