Organization
KELLY COLLABORATIVE CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY HETTICH-KELLY FNP-BC, RNCS (OWNER)
(774) 487-7647
Entity
Organization
Contact information
Practice address
616 ROUTE 6A, DENNIS, MA 02638-1906
(773) 487-7647
Mailing address
180 OLD RED TOP RD, BREWSTER, MA 02631-2370
(774) 487-7647
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
197116
MA
Other
Enumeration date
06/16/2010
Last updated
12/13/2010
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