Individual
JENNIFER KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
712 N 8TH ST, CARLTON, OR 97111-1233
(503) 849-9661
Mailing address
712 N 8TH ST, CARLTON, OR 97111-1233
(503) 849-9661
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/09/2016
Last updated
09/09/2016
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