Individual
KENNETH E KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
1323 POPLAR ST, CLARKSTON, WA 99403-2345
(509) 254-7725
Mailing address
1323 POPLAR ST, CLARKSTON, WA 99403-2345
(509) 254-7725
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSW-44165
ID
Other
Enumeration date
08/14/2024
Last updated
08/14/2024
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