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1104424456
CARISSA KELLY
PORT ST LUCIE, FL
NPI
1104424456
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2020-10-09
Last Update Date
2022-09-29
Business Address
CARISSA KELLY
1887 SE PORT ST LUCIE BLVD
PORT ST LUCIE, FL 34952-5530
Phone number: 772-463-0444
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Mailing Address
CARISSA KELLY
2215 MERION DR APT 206
MELBOURNE, FL 32935-5619
Phone number:
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