Provider Information for 1821222159
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EILEEN KELLEY MFT
Sex: Female
NPI: 1821222159
Last Updated: 2009-05-14
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1821222159 | ||||||||
| Enumeration Date | 2009-05-14 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1767 MARKET ST SUITE A REDDING, CA 96001-1940 United States Phone: 530-209-2847 | Fax: | ||||||||
| Primary Practice Address | 1767 MARKET ST SUITE A REDDING, CA 96001-1940 United States Phone: 530-209-2847 | Fax: | ||||||||
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