Individual
DANIEL CLARK KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDCA
Contact information
Practice address
6753 STATE RD, PARMA, OH 44134-4517
(440) 843-5584
Mailing address
6753 STATE RD, PARMA, OH 44134-4517
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.167521
OH
Other
Enumeration date
07/11/2018
Last updated
07/11/2018
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