Individual
RACHAEL KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3503 SW 52ND AVE APT 101, HOLLYWOOD, FL 33023-5430
(954) 348-0369
Mailing address
3503 SW 52ND AVE APT 101, HOLLYWOOD, FL 33023-5430
(954) 348-0369
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003598400
—
FL
Enumeration date
07/22/2014
Last updated
07/22/2014
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