Individual
TRACY L KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
50 WOODBRIDGE AVE, CHATHAM, NY 12037-1317
(518) 392-2400
Mailing address
PO BOX 43, EAST CHATHAM, NY 12060-0043
(518) 392-6556
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
073971-1
NY
Other
Enumeration date
12/23/2011
Last updated
12/23/2011
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