Individual
KRYSTAL KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
27 HOLMES DR, WINDSOR, CT 06095-3969
(860) 905-4776
Mailing address
27 HOLMES DR, WINDSOR, CT 06095-3969
(860) 778-5015
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
004885
CT
101YM0800X
Mental Health Counselor
004885
CT
101YP2500X
Professional Counselor
Primary
004885
CT
Other
Enumeration date
11/06/2021
Last updated
01/04/2023
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