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Individual

MS. KATHLEEN ANN KELLEHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
30 CHASE AVE, EDMUND ERVIN PEDIATRIC CENTER, WATERVILLE, ME 04901-4624
(207) 872-4390
(207) 872-4294
Mailing address
48 JOHNSON HTS, WATERVILLE, ME 04901-4907
(207) 873-1705

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT982
ME
2251P0200X
Pediatric Physical Therapist
PT982
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PT982
PHYSICAL THERAPY LICENSE
ME
Enumeration date
04/26/2007
Last updated
09/11/2025
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