Individual
MS. MARY LEE KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
4645 SAMUELL BLVD, DALLAS, TX 75228-6826
(214) 743-1200
Mailing address
6619 WHITNEYGLEN DR, DALLAS, TX 75241-3785
(214) 414-6797
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15183
TX
Other
Enumeration date
11/07/2021
Last updated
05/20/2022
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