| Doctor Name: | MRS. KATHLEEN RUTH KELLY |
| NPI Number: | 1164559068 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW C |
| License Number: | 3225 |
| Business Practice Address: | 1810 Bel Air Rd Suite 203 Fallston, MD - 210472729 |
| Business Phone Number: | 4108797269 |
| Business Fax Number: | 4108797269 |
| Mailing Address: | 1810 Bel Air Rd, Suite 203 FALLSTON |
| State: | MD |
| Postal Code: | 210472729 |
| Phone Number: | 4108797269 |
| Fax Number: | 4108797269 |
| NPI Enumeration Date: | 02/27/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 3225 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |