Provider Information for 1811386659
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KELLI WARREN LLMSW
Sex: Female
NPI: 1811386659
Last Updated: 2015-01-16
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1811386659 | ||||||||
| Enumeration Date | 2015-01-16 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 279 SUMMIT DR WATERFORD, MI 48328-3364 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 279 SUMMIT DR WATERFORD, MI 48328-3364 United States Phone: 248-745-4900 | Fax: | ||||||||
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