Individual
KELLEY BEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
27 NOBLE AVE UNIT 3, GROTON, CT 06340-5624
(413) 265-1813
Mailing address
27 NOBLE AVE UNIT 3, GROTON, CT 06340-5624
(413) 265-1813
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
005129
CT
235Z00000X
Speech-Language Pathologist
7739
MA
Other
Enumeration date
06/13/2014
Last updated
11/03/2019
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