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1477030823
THOMAS JOHN KELLY
WESTBROOK, ME
NPI
1477030823
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: ME LC3444)
Enumeration Date
2018-07-27
Last Update Date
2018-07-27
Business Address
THOMAS JOHN KELLY LADC
1 DELTA DR
WESTBROOK, ME 04092-4745
Phone number: 207-853-7227
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Mailing Address
THOMAS JOHN KELLY LADC
10 BROOKSIDE DR
CUMBERLAND, ME 04021-4057
Phone number: 207-357-3774
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