Miss Shijuan Kelly LMSW
Clinical Social Worker in Port Huron, MI(View on Map)
Full Name
Miss Shijuan Kelly LMSW
NPI Number
1558793612
NPI Type
Individual Provider
Gender
Female
Enumeration Date
07/31/2013
Specialties
(Taxonomies)Licenses
State
Michigan
License Number
6801093330
Contact
Information
Purpose
Mailing
Location
Address
520 SUPERIOR STREET
520 SUPERIOR STREET
City
Port Huron
Port Huron
State
MI
MI
Postal Code
48060-3541
48060-3541
Country
US
US
Telephone Number
(810) 984-4202
(810) 984-4202
Identifiers
Identifier
1558793612
Identifier State
MI
Identifier Issuer
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 07/11/2024
Provider Address
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