Organization
KELLY A. SCHMIDT, PH.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KELLY A. SCHMIDT PH.D. (OWNER)
(860) 871-5402
Entity
Organization
Contact information
Practice address
16 MAIN ST., ELLINGTON, CT 06029-0061
(860) 871-5402
(860) 871-5413
Mailing address
16 MAIN ST., ELLINGTON, CT 06029-0061
(860) 871-5402
(860) 871-5413
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008093888
—
CT
Enumeration date
09/19/2024
Last updated
09/19/2024
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