Individual
MARY KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3780 HIGHWAY 62, RIDGWAY, CO 81432-9702
(970) 729-1578
Mailing address
3780 HIGHWAY 62, RIDGWAY, CO 81432-9702
(970) 729-1578
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSW.0009926409
CO
Other
Enumeration date
08/11/2025
Last updated
08/11/2025
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