Individual
MRS. KAITLYN KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT-BC, LCAT
Contact information
Practice address
115 E ROE BLVD, PATCHOGUE, NY 11772-2629
(917) 617-7923
Mailing address
115 E ROE BLVD, PATCHOGUE, NY 11772-2629
(917) 617-7923
Taxonomy
Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
001820-01
NY
Other
Enumeration date
09/16/2021
Last updated
09/16/2021
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