Individual
MS. MARY JEAN KELLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
9812 SHELBYVILLE RD, SUITE 4, LOUISVILLE, KY 40223-2906
(502) 423-0509
(502) 423-1599
Mailing address
9812 SHELBYVILLE RD, SUITE 4, LOUISVILLE, KY 40223-2906
(502) 423-0509
(502) 423-1599
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
954
KY
Other
Enumeration date
01/08/2007
Last updated
07/08/2007
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