Individual
CRYSTAL KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
237 MOUNTAIN RD, GLASTONBURY, CT 06033-1508
(860) 281-9446
Mailing address
237 MOUNTAIN RD, GLASTONBURY, CT 06033-1508
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000
00000
—
Enumeration date
06/24/2021
Last updated
06/24/2021
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