Individual
MRS. KELLY LYNN KNODE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSC-AD
Contact information
Practice address
13114 PENNSYLVANIA AVE, HAGERSTOWN, MD 21742-2741
(240) 313-3254
(240) 313-3239
Mailing address
13114 PENNSYLVANIA AVE, HAGERSTOWN, MD 21742-2741
(240) 313-3254
(240) 313-3239
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
SC060
MD
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
SC0630
MD
Other
Enumeration date
05/12/2008
Last updated
05/12/2008
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