Detra Kelly, LCSW-C
Counselor, Mental Health in Salisbury, MD. Individual provider (NPI-1).
NPI number1982245049
StatusActive
Last updated in NPPESSep 30, 2019
Details
- NPI
- 1982245049
- Entity type
- Individual (NPI-1)
- Name
- Ms. Detra Kelly
- Credential
- LCSW-C
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 30, 2019
- Last updated
- Sep 30, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | 22747 | MD | Yes |
Practice location
540 Riverside Dr Ste 8Salisbury, MD 21801-5352
Phone 410-548-3333 · Fax 410-548-3341
Mailing address
540 Riverside Dr Ste 8Salisbury, MD 21801-5352
Phone 410-548-3333 · Fax 410-548-3341
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