Individual
KELLY GRACE WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
41 SPRUCE ST, NORTHFORD, CT 06472-1437
(203) 871-9984
Mailing address
41 SPRUCE ST, NORTHFORD, CT 06472-1437
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
3447
CT
104100000X
Social Worker
—
—
Other
Enumeration date
05/28/2017
Last updated
05/28/2017
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