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Individual
KRISTEN KELLY CONNOLLY
Active
Individual
KRISTEN KELLY CONNOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC, MA
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
151.0131969
VT
Other
Enumeration date
10/20/2017
Last updated
10/20/2017
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