Individual
KELLY MACDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
1260 RANDOLPH RD, PLAINFIELD, NJ 07060-3317
(800) 969-5300
Mailing address
1260 RANDOLPH RD, PLAINFIELD, NJ 07060-3317
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL07182500
NJ
Other
Enumeration date
09/23/2024
Last updated
04/17/2026
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