Doctor Name: | MS. DOROTHY C MCKELLICK |
NPI Number: | 1144489741 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCPC |
License Number: | XL2377 |
Business Practice Address: | 284 Main Street - Suite 390 Care & Comfort Wilton, ME - 04294 |
Business Phone Number: | 2076455304 |
Business Fax Number: | |
Mailing Address: | 630 Piscataquis St, RUMFORD |
State: | ME |
Postal Code: | 042761819 |
Phone Number: | 2073230069 |
Fax Number: | |
NPI Enumeration Date: | 06/09/2008 |
NPI Last Update Date: | 08/30/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | XL2377 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |