Individual
THOMAS LEO KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2947 THINNES ST, CROSS PLAINS, WI 53528-9540
(608) 576-6151
Mailing address
2947 THINNES ST, CROSS PLAINS, WI 53528-9540
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
268-228
WI
Other
Enumeration date
10/15/2012
Last updated
10/15/2012
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