Individual
MISS JENNIFER MARIE KELLEHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
22250 PROVIDENCE DR, SOUTHFIELD, MI 48075-4825
(248) 849-3940
Mailing address
22250 PROVIDENCE DR, SOUTHFIELD, MI 48075-4825
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302029952
MI
Other
Enumeration date
02/25/2008
Last updated
04/04/2013
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