Individual
MARGIE KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1155 W GROVE PKWY APT 113, TEMPE, AZ 85283-4411
(480) 733-3053
Mailing address
1155 W GROVE PKWY APT 113, TEMPE, AZ 85283-4411
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
1161157
AZ
Other
Enumeration date
05/26/2009
Last updated
05/26/2009
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