Individual
DR. GWYNETTH E KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DBH
Contact information
Practice address
15600 N BLACK CANYON HWY # C103, PHOENIX, AZ 85053-4055
(602) 320-7925
(877) 958-9033
Mailing address
PO BOX 86881, PHOENIX, AZ 85080-6881
(602) 320-7925
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-15492
AZ
Other
Enumeration date
12/04/2006
Last updated
08/06/2021
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