Individual
JILLIAN KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
835 BLOOMFIELD AVE, WINDSOR, CT 06095-2363
(860) 413-9538
Mailing address
166 WOODRUFF AVE, WATERTOWN, CT 06795-2548
(203) 525-1210
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
911
CT
Other
Enumeration date
04/13/2020
Last updated
04/13/2020
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