Individual
MS. REBECCA ELIZABETH KELLERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
158 WILSON RD, SPARROW BUSH, NY 12780-5440
(845) 858-8374
Mailing address
158 WILSON RD, P.O. BOX 447, SPARROW BUSH, NY 12780-5440
(845) 858-8374
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/24/2010
Last updated
05/24/2010
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