Individual
MS. DETRA KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
540 RIVERSIDE DR STE 8, SALISBURY, MD 21801-5352
(410) 548-3333
(410) 548-3341
Mailing address
540 RIVERSIDE DR STE 8, SALISBURY, MD 21801-5352
(410) 548-3333
(410) 548-3341
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
22747
MD
Other
Enumeration date
09/30/2019
Last updated
09/30/2019
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