| Doctor Name: | MRS. JOSEPHINE SALLY KELLY |
| NPI Number: | 1134249873 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MAMFC MA OF MARRIAGE |
| License Number: | 12570 |
| Business Practice Address: | 101 E Walker St Suite 512 & 513 Breckenridge, TX - 76424 |
| Business Phone Number: | 2545598508 |
| Business Fax Number: | 2545598508 |
| Mailing Address: | 101 E Walker St, Suite 512 & 513 BRECKENRIDGE |
| State: | TX |
| Postal Code: | 76424 |
| Phone Number: | 2545598508 |
| Fax Number: | 2545598508 |
| NPI Enumeration Date: | 03/29/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 12570 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |