Individual
KELLY JO FARACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ALCOHOL & DRUG TRAIN
Contact information
Practice address
122 LANGLEY ROAD NORTH, SUITE B, GLEN BURNIE, MD 21060
(410) 222-0100
(410) 222-0116
Mailing address
122 LANGLEY ROAD NORTH, SUITE B, GLEN BURNIE, MD 21060
(410) 222-0100
(410) 222-0116
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
MD
Other
Enumeration date
07/27/2010
Last updated
07/27/2010
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