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NPI 1154451904

NPI 1154451904 : DR. KAREN L.M. KELLEY : BELFAST, ME

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General NPI Number Information
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    NPI Number           |    1154451904
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    Entity Type          |    Individual 
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    Provider Name        |    DR. KAREN L.M. KELLEY
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/07/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    143 HIGH ST SUITE 25
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    City                 |    BELFAST
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    State                |    ME
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    Zip                  |    04915-6548
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    Country              |    US
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    Telephone            |    207-338-6104
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    11 KELHAM LANE 
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    City                 |    SEARSPORT
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    State                |    ME
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    Zip                  |    04974-0235
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    Country              |    US
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    Telephone            |    207-338-6104
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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        |    101Y00000X
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    Taxonomy Name        |    Counselor
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    License Number       |    
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    License Number State |    
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