Individual
TINA M. KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
145 MORELAND AVE, WATERBURY, CT 06705-2928
(203) 597-8734
Mailing address
145 MORELAND AVE, WATERBURY, CT 06705-2928
(203) 597-8734
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/02/2020
Last updated
04/02/2020
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