Individual
DEVEETA R KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
724 E LACLEDE AVE, YOUNGSTOWN, OH 44502-2344
(330) 314-2538
Mailing address
724 E LACLEDE AVE, YOUNGSTOWN, OH 44502-2344
(330) 314-2538
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
401697611014
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
401697611014
—
OH
Enumeration date
07/06/2020
Last updated
07/06/2020
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