Individual
KELLY KAY MICHLENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
245 W RACE ST, SOMERSET, PA 15501-1922
(814) 443-4891
Mailing address
245 W RACE ST, SOMERSET, PA 15501-1922
(814) 443-4891
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
BH004627
PA
Other
Enumeration date
05/19/2020
Last updated
05/19/2020
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