Doctor Name: | MS. SUSAN R KELLEY |
NPI Number: | 1093844193 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED. |
License Number: | PENDING |
Business Practice Address: | 200 Ter Heun Dr Falmouth, MA - 025402525 |
Business Phone Number: | 5085406550 |
Business Fax Number: | 5085407480 |
Mailing Address: | 128 Locust St, FALMOUTH |
State: | MA |
Postal Code: | 025402659 |
Phone Number: | 5085403363 |
Fax Number: | |
NPI Enumeration Date: | 03/05/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | PENDING |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |