Individual
GORDAN KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW-ACP
Contact information
Practice address
6387B CAMP BOWIE BLVD # 156, FT WORTH, TX 76116-5423
(817) 732-4225
Mailing address
6387B CAMP BOWIE BLVD # 156, FT WORTH, TX 76116-5423
(817) 732-4225
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S00473
TX
Other
Enumeration date
03/26/2007
Last updated
07/09/2007
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