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Individual
KELLY THERESA TOBIN
Active
Individual
KELLY THERESA TOBIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
084503
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
009549
CT
Other
Enumeration date
09/13/2019
Last updated
03/02/2021
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