Provider Information for 1154763589
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CARYN KELLEY LCSW
Sex: Female
NPI: 1154763589
Last Updated: 2013-07-26
Certification Date:
Certification Date:
Details
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NPI | 1154763589 | ||||||||
Enumeration Date | 2013-07-26 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | YES | ||||||||
Status | Active | ||||||||
Mailing Address | 607 7TH ST WILMETTE, IL 60091-1919 United States Phone: 847-251-0332 | Fax:847-251-0332 | ||||||||
Primary Practice Address | 607 7TH ST WILMETTE, IL 60091-1919 United States Phone: 847-251-0332 | Fax:847-251-0332 | ||||||||
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