Individual
MRS. KELLY BEAUDRY KLASTAVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
135 N PARKE ST, ABERDEEN, MD 21001-2428
(443) 625-1600
Mailing address
15 ARLEN RD, APARTMENT I, NOTTINGHAM, MD 21236-5165
(732) 456-0829
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
16610
MD
Other
Enumeration date
05/31/2012
Last updated
11/13/2013
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