Individual
MS. KELLY SU LIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, CLT
Contact information
Practice address
65 MEMORIAL RD, SUITE 410, WEST HARTFORD, CT 06107-2434
(860) 368-1648
Mailing address
PO BOX 230861, HARTFORD, CT 06123-0861
(860) 368-1648
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
6200
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1856
STATE OF COLORADO MASSAGE THERAPY LICENSE
CO
Enumeration date
05/10/2007
Last updated
03/23/2013
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