Individual
KELLY LYNN O'HERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
140 COMMERCIAL BLVD, TORRINGTON, CT 06790-3098
(860) 482-8796
Mailing address
140 COMMERCIAL BLVD, TORRINGTON, CT 06790-3098
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
001408
CT
Other
Enumeration date
08/11/2021
Last updated
08/11/2021
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