Kelley, Kaitlyn Rose

Kelley, Kaitlyn Rose is an sole proprietor health care provider with primary practice located at 2575 Triad Rd , Saint Jacob IL 62281-1125. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Kelley, Kaitlyn Rose can be contacted via phone (618) 978-5847.

Contact Information

Primary practice address
2575 Triad Rd Saint Jacob IL 62281-1125
Phone: (618) 978-5847
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X

Profile Details

NPI number 1386108173
LBN Legal business name Kelley, Kaitlyn Rose
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 25th, 2019
Last updated Jan 25th, 2019 - about 7 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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