Individual
MARY ELIZABETH KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
920 S PRAIRIE DR., F, SYCAMORE, IL 60178
(815) 899-0501
Mailing address
904 BORDEN AVE, SYCAMORE, IL 60178-3200
(815) 501-4449
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
180.006566
IL
Other
Enumeration date
03/06/2017
Last updated
03/06/2017
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