Individual
BRADLEY KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LLPC
Contact information
Practice address
340 WESTBROOK CT, MARSHALL, MI 49068-3121
(269) 910-4606
Mailing address
340 WESTBROOK CT, MARSHALL, MI 49068-3121
(269) 910-4606
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401015063
MI
Other
Enumeration date
05/24/2016
Last updated
05/24/2016
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