| Doctor Name: | MRS. KELLY CROOM |
| NPI Number: | 1427113810 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.ED., LCPC, NCC |
| License Number: | CC3489 |
| Business Practice Address: | 60 Front St Suite 10 Waterville, ME - 049016658 |
| Business Phone Number: | 2079444090 |
| Business Fax Number: | |
| Mailing Address: | Po Box 2876, WATERVILLE |
| State: | ME |
| Postal Code: | 049032876 |
| Phone Number: | 2079444090 |
| Fax Number: | |
| NPI Enumeration Date: | 12/26/2006 |
| NPI Last Update Date: | 04/20/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | CC3489 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |