Individual
DELASANDRA KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLBSW
Contact information
Practice address
331 HIGH ST, BENTON HARBOR, MI 49022-4523
(269) 419-7709
Mailing address
331 HIGH ST, BENTON HARBOR, MI 49022-4523
(269) 419-7709
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
01/26/2016
Last updated
01/26/2016
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