Individual
CAROLYN KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
110 ROACH ST, GEORGETOWN, KY 40324-9393
(502) 863-4734
Mailing address
98 TURNBERRY DR APT 2, FRANKFORT, KY 40601-3667
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
09/09/2013
Last updated
11/26/2014
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