Individual
MAMIE KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11710 BRIAR FOREST DR APT 1806, HOUSTON, TX 77077-5043
(616) 334-3602
Mailing address
11710 BRIAR FOREST DR APT 1806, HOUSTON, TX 77077-5043
(616) 334-3602
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/21/2021
Last updated
06/21/2021
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