Individual
MRS. MELISSA ANN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
21 NEW BRITAIN AVENUE, SUITE 215, ROCKY HILL, CT 06067
(860) 529-8977
Mailing address
68 PARISH DRIVE, KENSINGTON, CT 06037
(860) 828-0110
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
001163
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11668007
CAQH PROVIDER NUMBER
CT
Enumeration date
01/22/2007
Last updated
07/08/2007
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