| NPI | 1669623815 |
|---|---|
| Former Name | CAROL ANN KELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 7928) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CT 007928) |
| 101YM0800X Counselor, Mental Health (Licence: NY 073025) | |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2016-07-27 |