| Doctor Name: | ANNA MARIE DENNIS-KELLY |
| NPI Number: | 1033275383 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, CADC II |
| License Number: | |
| Business Practice Address: | 530 Nw 27th St Corvallis, OR - 973305223 |
| Business Phone Number: | 5417666835 |
| Business Fax Number: | 5417666186 |
| Mailing Address: | 530 Nw 27th St, CORVALLIS |
| State: | OR |
| Postal Code: | 973305223 |
| Phone Number: | 5417666835 |
| Fax Number: | 5417666186 |
| NPI Enumeration Date: | 12/29/2006 |
| NPI Last Update Date: | 08/08/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |