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Individual

MRS. KELLY YOUNG KELLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
1300 N 12TH ST, PHOENIX, AZ 85006-2848
(602) 839-3927
Mailing address
2915 E ESTRELLA CT, GILBERT, AZ 85296-8897
(860) 729-6288

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
006684
CT
1041C0700X
Clinical Social Worker
Primary
LMSW 13277
AZ

Other

Enumeration date
11/16/2006
Last updated
05/20/2011
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