Individual
KELLY MASSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSWAIC
Contact information
Practice address
7125 DAKOTA AVE, FAIRCHILD AFB, WA 99011-0001
(602) 574-5466
Mailing address
7125 DAKOTA AVE, FAIRCHILD AFB, WA 99011-0001
(602) 574-5466
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SWIA.SC.60918789
WA
Other
Enumeration date
03/25/2019
Last updated
11/16/2022
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