MISS Kelly Jean Mahla, LLP, PTA

NPI #1356551824 in Macomb, Michigan

Provider Information

NPI Number: 1356551824
Entity Type: Individual
Name: MISS Kelly Jean Mahla, LLP, PTA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: LLP, PTA
Enumeration Date: May 23, 2007
Last Updated: Nov 19, 2012

Practice Location

Address: 55753 SERENE DR
City: Macomb
State: Michigan
ZIP Code: 48042-6164
Phone: (586) 216-3815

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X
Massage Therapist	225700000X	Primary

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