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Contact Information

KELLY R CORLEY
204 G ST
204 G ST
PETALUMA, CA94954
 Phone: 707-775-8232
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for KELLY R CORLEY · (Female)

NPI # 1265988893
Status Active
Credentials
Entity Individual
Enumeration date 09/01/2016
Last updated 09/01/2016 - About 10 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # 66000
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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