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KELLY GRACE WHITE LMSW

>> Social Worker >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1396273801

Individual Registrant:
 KELLY GRACE WHITE LMSW
Gender: F
Sole Proprietor

Location and contact information for practice:
41 SPRUCE ST  NORTHFORD, CT 06472-1437 US
Tel: 203-871-9984  Fax: --

Contact information for business:
41 SPRUCE ST  NORTHFORD, CT 06472-1437 US
Tel: --  Fax: --

Registration Information:
NPI: 1396273801
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N104100000XBehavioral Health & Social Service Providers
Social Worker
Y104100000XBehavioral Health & Social Service Providers
Social Worker
CT3447

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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