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Individual

VANESSA ELIZABETH KELLAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
949 BRIDGPORT AVE, MILFORD, CT 06460
(203) 878-6365
Mailing address
949 BRIDGEPORT AVE, MILFORD, CT 06460-3142

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101YM0800X
CT
Enumeration date
06/14/2017
Last updated
06/14/2017
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