Individual
FREDERICA KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
29 MAPLE ST FL 2, FLORENCE, MA 01062-1242
(413) 584-7633
Mailing address
29 MAPLE ST FL 2, FLORENCE, MA 01062-1242
(413) 584-7633
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
4368
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LM0737
BLUE CROSS NUMBER
MA
Enumeration date
02/08/2007
Last updated
07/08/2007
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