Individual
LISA KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 ANNA MARSH LANE, BRATTLEBORO, VT 05301
(800) 738-7328
Mailing address
PO BOX 803, BRATTLEBORO, VT 05302-0803
(802) 258-3753
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089.0099299
VT
Other
Enumeration date
10/12/2016
Last updated
10/12/2016
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