Individual
DELTA KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2000 BERRY CHASE PL, MONTGOMERY, AL 36117-6896
(334) 669-1944
Mailing address
2000 BERRY CHASE PL, MONTGOMERY, AL 36117-6896
(334) 669-1944
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C3262A
AL
Other
Enumeration date
03/25/2020
Last updated
03/25/2020
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