Individual
KELLIE EAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
28 HAUGHTON RD, BOZRAH, CT 06334-1207
(860) 917-0790
(608) 371-2624
Mailing address
191 SPICER HILL RD, LEDYARD, CT 06339-1535
(860) 917-0790
(860) 371-2624
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/14/2014
Last updated
09/09/2021
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