Individual
DEDRAE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLPC
Contact information
Practice address
401 N KEENE ST, COLUMBIA, MO 65201-6625
(573) 874-8818
(573) 441-2668
Mailing address
401 N KEENE ST, COLUMBIA, MO 65201-6625
(573) 874-8818
(573) 441-2668
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2019012965
MO
Other
Enumeration date
04/25/2019
Last updated
04/25/2019
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