Doctor Name: | MRS. ELIZABETH A. KELLAWAY |
NPI Number: | 1083709117 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW |
License Number: | 6801070479 |
Business Practice Address: | 1570 Suncrest Dr Lapeer, MI - 484461154 |
Business Phone Number: | 8106670500 |
Business Fax Number: | |
Mailing Address: | 4320 Newburg Rd, BANCROFT |
State: | MI |
Postal Code: | 484149798 |
Phone Number: | 8106670500 |
Fax Number: | |
NPI Enumeration Date: | 10/04/2006 |
NPI Last Update Date: | 02/03/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 6801070479 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |