Individual
KELLY ABERNETHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
14 OTIS AVE, KITTERY, ME 03904-1729
(207) 752-1991
Mailing address
14 OTIS AVE, KITTERY, ME 03904-1729
(207) 752-1991
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC6881
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
435479099
—
ME
Enumeration date
09/15/2009
Last updated
11/01/2012
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