Individual
KELLY THIERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
702 15TH ST NE, WASHINGTON, DC 20002-4508
(240) 968-9873
Mailing address
702 15TH ST NE, WASHINGTON, DC 20002-4508
(240) 968-9873
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
12/16/2024
Last updated
05/22/2025
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