Individual
ANGELINE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AMFT
Contact information
Practice address
1006 PHILLIPS AVE, PETALUMA, CA 94952-4829
(707) 494-7311
Mailing address
1006 PHILLIPS AVE, PETALUMA, CA 94952-4829
(707) 494-7311
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
136742
CA
Other
Enumeration date
03/03/2022
Last updated
02/26/2025
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