Individual
KELLY COPELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1200 HIGH RIDGE RD, STAMFORD, CT 06905-1223
(203) 539-1033
Mailing address
36 RIDGE BROOK LN, STAMFORD, CT 06903-1239
(585) 245-3900
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3704
CT
Other
Enumeration date
12/28/2019
Last updated
12/28/2019
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