Individual
MRS. KATHLEEN KITTILA BEAULIEU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
5114 N CHARLES ST, BALTIMORE, MD 21210-2021
(410) 649-3315
Mailing address
116 ELMA DR, NEWARK, DE 19711-8524
(302) 456-1791
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/18/2007
Last updated
07/08/2007
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