Individual
TARA KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
309 S 7TH ST STE A, ADEL, IA 50003-1838
(515) 577-4373
Mailing address
805 SE FINCH CIR, WAUKEE, IA 50263-8618
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
001385
IA
Other
Enumeration date
06/20/2011
Last updated
06/20/2011
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