Doctor Name: | ANNA KELLY |
NPI Number: | 1073756680 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 91 North 1850 West Cedar City, UT - 84720 |
Business Phone Number: | 4358656481 |
Business Fax Number: | |
Mailing Address: | 474 W 200 N, ST GEORGE |
State: | UT |
Postal Code: | 847704505 |
Phone Number: | 4355864223 |
Fax Number: | |
NPI Enumeration Date: | 04/13/2009 |
NPI Last Update Date: | 04/13/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |