Individual
SAMANTHA ANN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
1812 CENTRE CREEK DR STE 115, AUSTIN, TX 78754-5133
(512) 579-0184
Mailing address
1801 WELLS BRANCH PKWY APT 1614, AUSTIN, TX 78728-6918
(318) 655-5077
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
—
—
183700000X
Pharmacy Technician
Primary
281242
TX
Other
Enumeration date
01/02/2020
Last updated
01/02/2020
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