Individual
KELLY CONRAD SANCHEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
1000 MAIN ST, PORT JEFFERSON, NY 11777-2250
(631) 296-1113
Mailing address
107 W MAIN ST, EAST ISLIP, NY 11730-2337
(631) 666-1615
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
2091
NY
Other
Enumeration date
04/14/2023
Last updated
05/16/2023
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