Individual
ASYA ROJAE KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8419 WIDGEON WAY, DALLAS, TX 75249-2205
(682) 540-1038
Mailing address
8419 WIDGEON WAY, DALLAS, TX 75249-2205
(682) 540-1038
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
10/05/2017
Last updated
10/05/2017
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