| Kelly Kent Spallone Pllc | |
|
86 Triangle Lake Rd Howell MI 48843-7955 | |
| (734) 726-0048 | |
| Not Available |
| Full Name | Kelly Kent Spallone Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 86 Triangle Lake Rd, Howell, Michigan |
| Authorized Official Name and Position | Mary Beth Houpt (CREDENTIALING) |
| Authorized Official Contact | 5176769797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Kent Spallone Pllc Po Box 10 Mason MI 48854-0010 Ph: () - | Kelly Kent Spallone Pllc 86 Triangle Lake Rd Howell MI 48843-7955 Ph: (734) 726-0048 |
| NPI Number | 1801570478 |
|---|---|
| Provider Enumeration Date | 06/13/2023 |
| Last Update Date | 06/13/2023 |
| Certification Date | 06/13/2023 |
| Medicare PECOS PAC ID | 2769840008 |
|---|---|
| Medicare Enrollment ID | O20230620001081 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801570478 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Kelly J Spallone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851864359 PECOS PAC ID: 2668714833 Enrollment ID: I20190509000047 |
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