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Individual

MRS. ALISA COLLEEN KELLY-MARTINA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSSW, LCSW

Contact information

Practice address
629 RIVER ST, BELLEVILLE, WI 53508-9189
(608) 424-9100
(608) 424-9099
Mailing address
107 EDWARD ST, VERONA, WI 53593-1005
(608) 424-0710
(608) 424-9099

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7189-123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40932200
WI
Enumeration date
03/16/2007
Last updated
06/10/2025
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