Individual
KELLY J. GARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OQMHP-C
Contact information
Practice address
7 PROSPECT ST, CARIBOU, ME 04736-2456
(207) 492-1000
(207) 492-1006
Mailing address
PO BOX 87, CARIBOU, ME 04736-0087
(207) 492-1000
(207) 492-1006
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
ME
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103850000
—
ME
Enumeration date
06/16/2011
Last updated
05/29/2013
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