MS. Kelly Gray Ezickson, LICSW
NPI #1043284839 in Quincy, Massachusetts
Provider Information
- NPI Number
- 1043284839
- Entity Type
- Individual
- Name
- MS. Kelly Gray Ezickson, LICSW
- Gender
- Not Specified
- Sole Proprietor
- Not Answered
- Primary Specialty
- Social Worker
- Credential
- LICSW
- Enumeration Date
- Feb 16, 2006
- Last Updated
- Jul 9, 2007
Practice Location
- Address
- 29 COTTAGE AVE SUITE 11
- City
- Quincy
- State
- Massachusetts
- ZIP Code
- 02169
- Phone
- (617) 472-9838
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker |
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