Individual
KELLIE FARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
17505 N 79TH AVE STE 410, GLENDALE, AZ 85308-8732
(623) 800-7980
Mailing address
39625 N 1ST PL, PHOENIX, AZ 85086-7512
(520) 465-2343
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-18218
AZ
Other
Enumeration date
02/10/2021
Last updated
02/10/2021
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