Individual
JOSEPH B KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
3600 VETERANS DR, SUITE 3, TRAVERSE CITY, MI 49684-4582
(231) 933-4009
(231) 933-4032
Mailing address
PO BOX 45, PORTAGE, IN 46368-0045
(219) 787-1510
(219) 787-8761
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401005316
MI
Other
Enumeration date
12/28/2006
Last updated
06/09/2009
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