Individual
LISA KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
117 FREE STREET, C/O HEADGAMES SPA, PORTLAND, ME 04106
(207) 239-9485
Mailing address
268 PREBLE ST, UNIT B, SOUTH PORTLAND, ME 04106-2232
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
MT4261
ME
Other
Enumeration date
08/06/2015
Last updated
08/06/2015
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