Fornwalt, Kelly

Fornwalt, Kelly is an individual health care provider with primary practice located at 271 S Main St , Plymouth MI 48170-1637. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Fornwalt, Kelly can be contacted via phone (734) 455-4095.

Contact Information

Primary practice address
271 S Main St Plymouth MI 48170-1637
Phone: (734) 455-4095
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X

Profile Details

NPI number 1174821938
LBN Legal business name Fornwalt, Kelly
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 3rd, 2011
Last updated Mar 3rd, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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