Individual
MRS. KATHLEEN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1401 LAKEWOOD DR, SUITE A, MORRIS, IL 60450-3352
(815) 942-6323
(815) 942-6423
Mailing address
1401 LAKEWOOD DR, SUITE A, MORRIS, IL 60450-3352
(815) 942-6323
(815) 942-6423
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
149001308
IL
Other
Enumeration date
06/07/2006
Last updated
12/06/2010
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