Individual
MS. LEONA M. KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
710 N 20TH ST APT A, FORT PIERCE, FL 34950-6105
(772) 940-6215
Mailing address
710 N 20TH ST APT A, FORT PIERCE, FL 34950-6105
(772) 940-6215
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
09/21/2019
Last updated
09/21/2019
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