Individual
MRS. SANDRA EMILY COUCH KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
410 BRIDGE ST, CONGIN SCHOOL, WESTBROOK, ME 04092-3185
(207) 854-0844
(207) 854-0846
Mailing address
13 NORTHLEDGE TER, FALMOUTH, ME 04105-2819
(207) 874-7994
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC6148
ME
Other
Enumeration date
01/12/2007
Last updated
07/08/2007
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