Individual
MRS. AUDREY ANN KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ADMINISTRATOR
Contact information
Practice address
22401 LYNDON ST, DETROIT, MI 48223-1856
(131) 364-1805
Mailing address
22401 LYNDON ST, DETROIT, MI 48223-1856
(313) 641-8054
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
MI
376K00000X
Nurse's Aide
Primary
236666620390
MI
Other
Enumeration date
07/12/2012
Last updated
06/27/2024
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