Individual
KELLY CARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21 ADDISON DR, FAIRFIELD, NJ 07004-1534
(862) 220-2285
Mailing address
139 ORCHARD ST, BLOOMFIELD, NJ 07003-5131
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS01175500
NJ
Other
Enumeration date
11/11/2024
Last updated
11/11/2024
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