Individual
MRS. EDILIA P KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
22-08 ROUTE 208, FAIR LAWN, NJ 07410-2609
(201) 956-6363
Mailing address
89 GATE HOUSE LN, EDISON, NJ 08820-4011
(201) 956-6363
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
37AC0017500
NJ
Other
Enumeration date
08/27/2013
Last updated
08/27/2013
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