Individual
DR. PATRICK LOUJOHN KELLY SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
5540 E BROADWAY RD, SUITE 13, MESA, AZ 85206-1440
(480) 830-8299
(480) 830-1820
Mailing address
5540 E BROADWAY RD, SUITE 13, MESA, AZ 85206-1440
(480) 830-8299
(480) 830-1820
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LISAC-1448
AZ
Other
Enumeration date
12/25/2009
Last updated
12/25/2009
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