Individual
CAROL P GRAY KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
836 MAIN STREET, WESTBROOK, ME 04092
(207) 712-1971
Mailing address
50 PRIDE STREET, WESTBROOK, ME 04092
(207) 712-1971
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC15858ME
ME
103T00000X
Psychologist
CC1858
ME
Other
Enumeration date
09/13/2006
Last updated
11/09/2016
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