Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | SW011786L | PA |
Y | 1041C0700X | Clinical Social Worker | ||
N | 1041C0700X | Clinical Social Worker | LCSW-4438 | HI |
NPI | 1003385212 |
---|---|
Provider Name | Ms. Janice Elizabeth Thron-Kelly |
First Address | Tucson, AZ 85723-0002 |
Second Address | Tucson, AZ 85723-5001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2018 |
Last Update Date | 04/02/2020 |