Tina M. Kelly

NPI #1295364115 in Waterbury, Connecticut

Provider Information

NPI Number: 1295364115
Entity Type: Individual
Name: Tina M. Kelly
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Apr 2, 2020
Last Updated: Apr 2, 2020

Practice Location

Address: 145 MORELAND AVE
City: Waterbury
State: Connecticut
ZIP Code: 06705-2928
Phone: (203) 597-8734

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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