Individual
KELSEY BROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC-C
Contact information
Practice address
32 N HIGH ST, BRIDGTON, ME 04009-1125
(207) 647-5629
Mailing address
PO BOX 170, BRIDGTON, ME 04009-0170
(207) 647-5629
(207) 647-5620
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
XL5124
ME
Other
Enumeration date
09/20/2018
Last updated
09/20/2018
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