Individual
KELLY MARIE MCNELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
703 W CHURCH ST, APT H, CHAMPAIGN, IL 61820-3352
(217) 474-0002
Mailing address
703 W CHURCH ST, APT H, CHAMPAIGN, IL 61820-3352
(217) 474-0002
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
04/11/2013
Last updated
04/11/2013
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