Individual
BEVERLY KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
150 W WALNUT PARK DR, PHILADELPHIA, PA 19120-1011
(267) 226-5096
Mailing address
150 W WALNUT PARK DR, PHILADELPHIA, PA 19120-1011
(267) 226-5096
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/04/2015
Last updated
11/04/2015
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