Individual
MICHLLE KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
224 MILL STREET EXT, LANCASTER, MA 01523-2004
(978) 503-9534
Mailing address
224 MILL STREET EXT, LANCASTER, MA 01523-2004
(978) 503-9534
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
222Q000X
MA
Other
Enumeration date
04/01/2014
Last updated
04/01/2014
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