Individual
KELLI SUE PORTLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5 N RIDGE CT, MILFORD, NJ 08848-1654
(908) 892-2048
Mailing address
5 N RIDGE CT, MILFORD, NJ 08848-1654
(908) 892-2048
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
NJ
Other
Enumeration date
08/14/2018
Last updated
08/14/2018
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