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General NPI Number Information
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NPI Number | 1023634904
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Entity Type | Individual
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Provider Name | BRIGID KELLY LSW
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Gender | Female
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Dates
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Enumeration Date | 06/17/2020
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Last Update Date | 06/17/2020
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Provider Practice Location Address
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Address Line | 739 CINNAMINSON AVE FL 2
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City | PALMYRA
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State | NJ
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Zip | 08065-2553
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Country | US
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Telephone | 609-553-4158
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Fax |
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Provider Business Mailing Address
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Address Line | 795 WOODLANE RD STE 301
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City | WESTAMPTON
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State | NJ
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Zip | 08060-3832
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Country | US
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Telephone | 609-553-4158
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SL05783700
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License Number State | NJ
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