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1043484702
SUSAN KELLY
HAMDEN, CT
NPI
1043484702
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CT 000634)
Enumeration Date
2008-04-14
Last Update Date
2008-04-14
Business Address
Ms. SUSAN KELLY LADC, CAC
1890 DIXWELL AVE
HAMDEN, CT 06514-3122
Phone number: 860-223-9291
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Mailing Address
Ms. SUSAN KELLY LADC, CAC
1890 DIXWELL AVE
HAMDEN, CT 06514-3122
Phone number: 860-223-9291
Copy
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