Most Relevant Information
Provider Data
| NPI Number: | 1003036583 |
| Provider Name: | MARY ANNE KELLY MFT, CDE |
| Entity Type: | Individual |
| Taxonomy Code: | 106H00000X |
| Specialty: | Marriage & Family Therapist |
| License Number: | MFC12717 |
Most Important Dates
| Enumeration Date: | 04/26/2007 |
| Last Updated: | 01/27/2016 |
Provider Practice Location
105 SUNNYSIDE AVE
PIEDMONT
CA
946114419
Practice Location Phone/Fax
| Phone: | 5106557943 |
| Fax: |
Provider Mailing Location
105 SUNNYSIDE AVE
PIEDMONT
CA
946114419
Provider Mailing Phone/Fax
| Phone: | 5106557943 |
| Fax: |