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Jazaiha Lanae Kelley
Addiction (Substance Use Disorder) Counselor in Modesto, California
NPI 1174202386

Jazaiha Lanae Kelley is an Addiction (Substance Use Disorder) Counselor based in Modesto, CA and is specialized in Addiction (Substance Use Disorder). Jazaiha Lanae Kelley practices in Modesto, CA. The NPI Number for Jazaiha Lanae Kelley is 1174202386 and holds a License No. (California).

The current practice location address for Jazaiha Lanae Kelley is 2700 Brenner Way, Modesto, CA and can be reached out via phone at 559-241-3239.

Location: 2700 Brenner Way, Modesto, CA, 95350-1704
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1174202386
Provider Name
Jazaiha Lanae Kelley
Credential
Provider Entity Type
Individual
Gender
Female
Address
2700 Brenner Way, Modesto, CA, 95350-1704
Phone Number
559-241-3239
Fax Number
Provider Enumeration Date
07/14/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2700 Brenner Way
City
Modesto
State
California
Zip
95350-1704
Phone Number
559-241-3239
Fax Number
person
Provider Business Mailing Address Details
Address
2700 Brenner Way
City
Modesto
State
California
Zip
95350-1704
Phone Number
559-241-3239
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
()
Definition
Definition to come...
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